Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 31154 | KY |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35.092370 | OH |
NPI | 1063476216 |
---|---|
Provider Name | Michael Eugene Fletcher |
First Address | Florence, KY 41042-6936 |
Second Address | Florence, KY 41042-6936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 07/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2838808 | (05) | OH |
64311541 | (05) | KY |