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NPI Code Detail

MEDICARE: DR. HERBERT PETER FECHTER III MD

MEDICARE: DR. HERBERT PETER FECHTER III MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207WX0009XGlaucoma Specialist (Ophthalmology) Physician058600GA
2207W00000XOphthalmology Physician058600GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
118BDGSPOTHERGAMEDICARE LEGACY

General Provider Information

NPI Number : 1063467454
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERBERT PETER FECHTER III MD
Provider Business Mailing Address
First Line : 1330 INTERSTATE PKWY
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-5625
Country : US
Telephone Number : 706-651-2020
Fax Number : 706-855-6674
Provider Business Practice Location Address
First Line : 1330 INTERSTATE PKWY
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-5625
Country : US
Telephone Number : 706-651-2020
Fax Number : 706-855-6674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 01/28/2019

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