Individual
JACOB FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11851 DETROIT AVE, LAKEWOOD, OH 44107-3016
(215) 529-7125
Mailing address
2835 FRED TAYLOR DR, COLUMBUS, OH 43202-1552
(256) 388-9114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.145947
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2017
Last updated
06/29/2022
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