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Individual

HOMER LUTHER FLEISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
525 WESTERN AVE, SUITE 203, CONWAY, AR 72034-4967
(501) 327-4828
(501) 327-6899
Mailing address
525 WESTERN AVE, SUITE 203, CONWAY, AR 72034-4967
(501) 327-4828
(501) 327-6899

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
N6929
AR
2086S0129X
Vascular Surgery Physician
N6929
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
111482001
AR
01
1720126
UNITED HEALTHCARE
AR
01
18016000000
QUALCHOICE
AR
01
5888645
AETNA
AR
Enumeration date
08/10/2005
Last updated
11/18/2009
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