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NPI Code Detail

MEDICARE: MR. ROD EUGENE FLEMING PT

MEDICARE: MR. ROD EUGENE FLEMING PT
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
1174400000XSpecialistCA9485CA
2174400000XSpecialist2476PTMT

General Provider Information

NPI Number : 1588738405
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROD EUGENE FLEMING PT
Provider Business Mailing Address
First Line : 548 OCEAN ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-6602
Country : US
Telephone Number : 831-423-3196
Fax Number : 831-423-0755
Provider Business Practice Location Address
First Line : 1343 US HIGHWAY 93 N
Second Line :
City : EUREKA
State : MT
Zip : 59917-9503
Country : US
Telephone Number : 406-297-3915
Fax Number : 406-297-3919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 03/23/2017

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