Provider Demographics
NPI:1497972533
Name:FLUKE, WILLIAM JEFFREY
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JEFFREY
Last Name:FLUKE
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 1:4970 NORTHWIND DR
Mailing Address - Street 2:SUITE 226
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5080
Mailing Address - Country:US
Mailing Address - Phone:517-336-1942
Mailing Address - Fax:517-336-1944
Practice Address - Street 1:724 N CLIPPERT ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4733
Practice Address - Country:US
Practice Address - Phone:517-333-0830
Practice Address - Fax:517-333-1519
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501002222237700000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No332S00000XSuppliersHearing Aid Equipment