Gordon Earl Fletcher, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3515 Issued in LA

Practice address

1904 Hardy St
Hattiesburg, MS 39401-4983

Phone

(601) 583-2250

Fax

(601) 583-2272

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1255350369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 S CLAIBORNE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701254603",
            "telephone_number": "504-289-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394014983",
            "telephone_number": "601-583-2250",
            "fax_number": "601-583-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "GORDON",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3268-03",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3515",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "PEDO3703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1835153",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Carey Fitzpatrick, MD
• John M Fitzpatrick, MD
• Madeline Campbell Fitzpatrick, MD
• Lindsey Flaccomio
• Gardner Fletcher, MD
• Stephen Gardner Fletcher, DO
• Victor A Fletcher, DDS FACP
• Alexandra C Flint, ATC
• Herbert Floyd, MD
• Chandra Shakira Foard, LPC

• General Practice Dentistry in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.