MEDICARE: DR. DONALD CALVIN FLETCHER M.D.

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	207QA0401X	Addiction Medicine (Family Medicine) Physician	04-33631	KS
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	10260037-1205	UT
3	207W00000X	Ophthalmology Physician	ME0052066	FL
4	207W00000X	Ophthalmology Physician	G56961	CA
5	207W00000X	Ophthalmology Physician	04-33631	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	180022165	OTHER	FL	RAILROAD MEDICARE
3	CA7010	OTHER	FL	RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
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	:	1689633638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD CALVIN FLETCHER M.D.

Provider Business Mailing Address
First Line	:	250 W DOUGLAS AVE APT 2516
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67202-3119
Country	:	US
Telephone Number	:	650-346-7760
Fax Number	:

Provider Business Practice Location Address
First Line	:	2340 CLAY ST # 514
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1932
Country	:	US
Telephone Number	:	415-600-3901
Fax Number	:	415-600-3949

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	10/28/2022

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