Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 34002350F | OH |
NPI | 1003857418 |
---|---|
Provider Name | John R Fearon |
First Address | Bellefontaine, OH 43311-2305 |
Second Address | Bellefontaine, OH 43311-2281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 18/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000026809 | ANTHEM (01) | |
010039356 | RR MEDICARE (01) | |
2051587 | (05) | OH |
341407259 | CIGNA (01) | |
341407259 | NATIONWIDE (01) | |
341407259037 | MEDICAL MUTUAL (01) | |
7755544 | AETNA (01) | |
87726 | UHC (01) | |
A83438 | (02) | |
FE0923062 | TRICARE (01) |