Healthcare Provider Details
I. General information
NPI: 1396852422
Provider Name (Legal Business Name): ALFRED J FLEMING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2006
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
974 BETHEL RD STE A
COLUMBUS OH
43214-2467
US
IV. Provider business mailing address
1810 MACKENZIE DR
COLUMBUS OH
43220-2967
US
V. Phone/Fax
- Phone: 614-538-2424
- Fax: 614-538-2418
- Phone: 614-273-2250
- Fax: 614-273-2255
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 35087423 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 35-087423 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: