Healthcare Provider Details

I. General information

NPI: 1043148117
Provider Name (Legal Business Name): FNU RICHARD FLEMING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DRIVE, FAMILY MEDICINE CLINIC SUIT G2
DALTON GA
30720
US

IV. Provider business mailing address

1200 MEMORIAL DRIVE, DALTON GA 30720, HAMILTON MEDICAL
DALTON GA
30720
US

V. Phone/Fax

Practice location:
  • Phone: 706-686-8015
  • Fax: 706-686-8221
Mailing address:
  • Phone: 706-226-8996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: