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Organization
JOHN A FETCHERO JR D O P A
Active
Organization
JOHN A FETCHERO JR D O P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTHONY FETCHERO JR. D O (PRESIDENT)
(904) 278-3820
Entity
Organization
Contact information
Practice address
1542 KINGSLEY AVE STE 140, ORANGE PARK, FL 32073-4547
(904) 278-3820
(904) 278-3849
Mailing address
2862 COUNTRY CLUB BLVD, ORANGE PARK, FL 32073-5728
(904) 278-3820
(904) 278-3849
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
NULL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/20/2006
Last updated
09/30/2010
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