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General NPI Number Information
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NPI Number | 1528327798
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Entity Type | Individual
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Provider Name | JOYCE WESLEY FLETCHER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 100 MAC LN
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City | PIERRE
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State | SD
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Zip | 57501-3391
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Country | US
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Telephone | 605-945-5901
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Fax |
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Provider Business Mailing Address
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Address Line | 820 E CABOT ST
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City | PIERRE
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State | SD
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Zip | 57501-2511
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Country | US
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Telephone | 210-884-9434
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 10095
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License Number State | SD
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