Healthcare Provider Details

I. General information

NPI: 1700601242
Provider Name (Legal Business Name): JAMAR FLEMING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CLEVELAND AVE SW
CANTON OH
44702-1904
US

IV. Provider business mailing address

120 CLEVELAND AVE SW
CANTON OH
44702-1904
US

V. Phone/Fax

Practice location:
  • Phone: 330-754-0192
  • Fax:
Mailing address:
  • Phone: 330-754-0192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: