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General NPI Number Information
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NPI Number | 1396962494
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Entity Type | Organization
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Legal Business Name | DAVID K FLETCHER MD PA
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 816 S FLEISHEL AVE
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City | TYLER
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State | TX
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Zip | 75701-2016
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Country | US
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Telephone | 903-592-2999
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Fax | 903-593-5190
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Provider Business Mailing Address
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Address Line | 816 S FLEISHEL AVE
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City | TYLER
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State | TX
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Zip | 75701-2016
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Country | US
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Telephone | 903-592-2999
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Fax | 903-593-5190
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MS. FRANCENE BELL
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Credential | R.N. CMOM
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Telephone | 903-592-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | C8971
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License Number State | TX
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