Provider Demographics
NPI:1356753453
Name:FETCHERO, JOHN III (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:FETCHERO
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-382-4972
Mailing Address - Fax:603-382-9305
Practice Address - Street 1:127 PLAISTOW RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2811
Practice Address - Country:US
Practice Address - Phone:603-382-4972
Practice Address - Fax:603-382-9305
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH20559207Q00000X
AK136496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012771700Medicaid
AK1691876Medicaid