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Individual

TERRY M. FLETCHER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3810
(423) 968-1144
(423) 968-3153
Mailing address
3053 W STATE ST, BRISTOL, TN 37620-1720
(423) 968-1144
(423) 968-3453

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
38712
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10159865
VA
05
3329461
TN
01
ANTHEM
180537
VA
01
R06903
JOHN DEERE
TN
Enumeration date
09/07/2005
Last updated
07/08/2007
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