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NPI Code Detail

MEDICARE: DR. FRANCIS LANIER FLY D.MIN

MEDICARE: DR. FRANCIS LANIER FLY D.MIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0717000127VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10717000127OTHERVALMFT
211239871OTHERUNIVERSAL CREDENTIALLING

General Provider Information

NPI Number : 1225114549
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANCIS LANIER FLY D.MIN
Provider Business Mailing Address
First Line : 718 J CLYDE MORRIS BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-1540
Country : US
Telephone Number : 757-873-8566
Fax Number : 757-873-8566
Provider Business Practice Location Address
First Line : 718 J CLYDE MORRIS BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-1540
Country : US
Telephone Number : 757-873-8566
Fax Number : 757-873-8566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2006
Last Update Date : 07/08/2007

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