Healthcare Provider Details
I. General information
NPI: 1578629226
Provider Name (Legal Business Name): RONALD W. FLECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/28/2006
Last Update Date: 03/06/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1175 CARONDELET DR
RICHLAND WA
99354-3300
US
IV. Provider business mailing address
PO BOX 563
BLANCHARD ID
83804-0563
US
V. Phone/Fax
- Phone: 509-546-2222
- Fax: 509-546-2202
- Phone: 509-240-5054
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | MD00019815 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: