John a Fetchero Jr D O P a

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

Legal business name

JOHN A FETCHERO JR D O P A

Practice address

1542 Kingsley Ave Ste 140
Orange Park, FL 32073-4547

Phone

(904) 278-3820

Fax

(904) 278-3849

NPI assigned

Jun 20, 2006

Last updated

Sep 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Anthony Fetchero Jr., D O

Title

President

Phone

(904) 278-3820

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1457397499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 COUNTRY CLUB BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735728",
            "telephone_number": "904-278-3820",
            "fax_number": "904-278-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE STE 140",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734547",
            "telephone_number": "904-278-3820",
            "fax_number": "904-278-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A FETCHERO JR D O P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "FETCHERO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-278-3820",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D O"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048447400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joann Denemark Inc.
• John J Harrington
• John M. Flinchbaugh D.O., P.L.
• Randy John, DC
• Laurie Carla Johns-Stoutamire, DMD
• Brenda Willis Johns, L.M.T.

• Otolaryngology/Facial Plastic Surgery Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.