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Individual

DR. BYRON K FLECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4740 MALL DRIVE, HERMANTOWN, MN 55811
(218) 727-1204
Mailing address
8664 EVERGREEN LN, COTTON, MN 55724-8109
(218) 482-3284

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2733
MN
152WC0802X
Corneal and Contact Management Optometrist
2788-035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
128886
U-CARE
MN
01
16525
SPECTERA
MN
01
22-03394
MEDICA
MN
01
22-03395
MEDICA
WI
01
37024
AVESIS
WI
01
37832
AVESIS
MN
01
43076
SPECTERA
MN
01
53M11FL
BLUE CROSS BLUE SHIELD
MN
01
647819
PA BLUE CROSS BLUE SHIELD
MN
01
647819
BCBS PA
WI
01
B25851028756
PREFERRED ONE
WI
01
B25861028756
PREFERRED ONE
MN
Enumeration date
10/02/2006
Last updated
08/13/2008
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