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NPI Code Detail

MEDICARE: LARRY LEE FLETCHER MD

MEDICARE: LARRY LEE FLETCHER 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
1208000000XPediatrics Physician12003NE

General Provider Information

NPI Number : 1184628133
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY LEE FLETCHER MD
Provider Business Mailing Address
First Line : 1021 N 27TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68503-1803
Country : US
Telephone Number : 402-476-1455
Fax Number : 402-476-1670
Provider Business Practice Location Address
First Line : 1021 N 27TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68503-1803
Country : US
Telephone Number : 402-476-1455
Fax Number : 402-476-1670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 06/07/2012

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Directions to “ LARRY LEE FLETCHER MD” Practice Location

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