Healthcare Provider Details

I. General information

NPI: 1245770965
Provider Name (Legal Business Name): JOHN L FLEMING, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2017
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 INTERNATIONAL CIR SUITE 100
COLORADO SPRINGS CO
80910-3161
US

IV. Provider business mailing address

3225 INTERNATIONAL CIR SUITE 100
COLORADO SPRINGS CO
80910-3161
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-7206
  • Fax: 719-471-8452
Mailing address:
  • Phone: 719-471-7206
  • Fax: 719-471-8452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20153
License Number StateCO

VIII. Authorized Official

Name: DR. JOHN LAWRENCE FLEMING
Title or Position: OWNER/OPERATOR
Credential: M.D.
Phone: 719-471-7206