Provider Demographics
NPI:1043474117
Name:FLETCHER, PATRICK LAWRENCE
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LAWRENCE
Last Name:FLETCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 915
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28093-0915
Mailing Address - Country:US
Mailing Address - Phone:704-735-9072
Mailing Address - Fax:704-735-5972
Practice Address - Street 1:102 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4406
Practice Address - Country:US
Practice Address - Phone:704-735-9072
Practice Address - Fax:704-735-5972
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19676OtherNC PHARMACIST LICENSE