Provider Demographics
NPI:1033230206
Name:FLEISCHLI, GERALD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:JOSEPH
Last Name:FLEISCHLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34977 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-9469
Mailing Address - Country:US
Mailing Address - Phone:541-895-2143
Mailing Address - Fax:
Practice Address - Street 1:1232 UNIVERSITY OF OREGON
Practice Address - Street 2:UNIVERSITY OF OREGON HEALTH CENTER
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-1232
Practice Address - Country:US
Practice Address - Phone:541-346-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine