Provider Demographics
NPI:1245498963
Name:FLETCHER, ALLEN B (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:B
Last Name:FLETCHER
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 1:5529 S WAVERLY WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2024
Mailing Address - Country:US
Mailing Address - Phone:480-777-0735
Mailing Address - Fax:480-777-0735
Practice Address - Street 1:5529 S WAVERLY WAY
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2024
Practice Address - Country:US
Practice Address - Phone:480-777-0735
Practice Address - Fax:480-777-0735
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12763207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology