Provider Demographics
NPI:1962469957
Name:FLESHER, JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:FLESHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:DAVID
Other - Last Name:FLESHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9350 E 35TH ST N STE 104
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2022
Mailing Address - Country:US
Mailing Address - Phone:316-201-1755
Mailing Address - Fax:316-201-1138
Practice Address - Street 1:9350 E 35TH ST N STE 104
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2022
Practice Address - Country:US
Practice Address - Phone:316-201-1755
Practice Address - Fax:316-201-1138
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28290207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100351170NMedicaid
KS100351170NMedicaid
H06840Medicare UPIN