Vance L Fletcher MD LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

13964 Issued in HI

Legal business name

VANCE L FLETCHER MD LLC

Practice address

91-2139 Fort Weaver Rd
Suite 311
Ewa Beach, HI 96706-3607

Phone

(808) 671-3715

Fax

(808) 677-2027

NPI assigned

Feb 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vance L Fletcher, M.D.

Title

Ceo

Phone

(808) 671-3715

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1740324201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD",
            "address_2": "SUITE 311",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-671-3715",
            "fax_number": "808-677-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD",
            "address_2": "SUITE 311",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-671-3715",
            "fax_number": "808-677-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCE L FLETCHER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-17",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "VANCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-671-3715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "HI",
            "license": "13964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589012",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Adult Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.