MEDICARE: ANDRENETTE M FLEMING 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
1	207V00000X	Obstetrics & Gynecology Physician	MD0000039552	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2033962	OTHER	TN	UNISON
2	39813	OTHER	TN	TLC
3	4143455	OTHER	TN	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396804266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRENETTE M FLEMING MD

Provider Business Mailing Address
First Line	:	165 BEN CV
Second Line	:
City	:	HENDERSON
State	:	TN
Zip	:	38340-1278
Country	:	US
Telephone Number	:	731-989-4339
Fax Number	:	901-383-7447

Provider Business Practice Location Address
First Line	:	9005 HIGHWAY 64
Second Line	:	SUITE 101
City	:	ARLINGTON
State	:	TN
Zip	:	38002-8391
Country	:	US
Telephone Number	:	901-383-7446
Fax Number	:	901-383-7447

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	06/07/2010

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