Provider Demographics
NPI:1255606430
Name:FLEMING, GARRETT WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:WILLIAM
Last Name:FLEMING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:123 HOSPITAL DR
Mailing Address - Street 2:STE 2000
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-3320
Mailing Address - Country:US
Mailing Address - Phone:563-584-4100
Mailing Address - Fax:
Practice Address - Street 1:1000 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7313
Practice Address - Country:US
Practice Address - Phone:563-584-3450
Practice Address - Fax:563-584-3171
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IADO-05037208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty