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NPI Code Detail

MEDICARE: BRYAN E FLUECKIGER MD

MEDICARE: BRYAN E FLUECKIGER 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
12084P0800XPsychiatry Physician01034281AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992705305
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN E FLUECKIGER MD
Provider Business Mailing Address
First Line : 1500 N OAKLAND AVE
Second Line :
City : BOLIVAR
State : MO
Zip : 65613-3011
Country : US
Telephone Number : 417-326-6000
Fax Number : 417-328-6338
Provider Business Practice Location Address
First Line : 1500 N OAKLAND AVE
Second Line :
City : BOLIVAR
State : MO
Zip : 65613-3011
Country : US
Telephone Number : 417-326-6000
Fax Number : 417-328-6338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 09/11/2014

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Directions to “ BRYAN E FLUECKIGER MD” Practice Location

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