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NPI Code Detail

MEDICARE: DR. JERRI LEE FLETCHER P.D.

MEDICARE: DR. JERRI LEE FLETCHER P.D.
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
1183500000XPharmacist06707AR

General Provider Information

NPI Number : 1881626950
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JERRI LEE FLETCHER P.D.
Provider Business Mailing Address
First Line : 360 HIGHWAY 64 W
Second Line :
City : BEEBE
State : AR
Zip : 72012-9508
Country : US
Telephone Number : 501-882-5849
Fax Number : 501-987-7605
Provider Business Practice Location Address
First Line : 1090 ARNOLD DR
Second Line :
City : LITTLE ROCK AIR FORCE BASE
State : AR
Zip : 72099-4933
Country : US
Telephone Number : 501-987-7446
Fax Number : 501-987-7605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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