Provider Demographics
NPI:1639699929
Name:DROGOS, JOHN FLETCHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FLETCHER
Last Name:DROGOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J. FLETCHER
Other - Middle Name:
Other - Last Name:DROGOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1532 N PAULINA ST APT P
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2158
Mailing Address - Country:US
Mailing Address - Phone:970-201-1914
Mailing Address - Fax:
Practice Address - Street 1:361 OLD BELGRADE RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8058
Practice Address - Country:US
Practice Address - Phone:207-621-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125070514390200000X
IL125-0705142085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program