Individual
EUGENE C FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 GOSHEN LN, GOSHEN, KY 40026-9509
(502) 228-2636
Mailing address
1600 GOSHEN LN, GOSHEN, KY 40026-9509
(520) 228-2636
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01046080A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
29686
KY
207RP1001X
Pulmonary Disease Physician
01046080A
IN
207RP1001X
Pulmonary Disease Physician
Primary
29686
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000311476
ANTHEM
KY
01
—
000000645210
ANTHEM BCBS
IN
05
—
200057650B
—
IN
01
—
2444577000
PASSPOSRT ADVANTAGE
KY
01
—
50003129
PASSPORT
KY
05
—
64296866
—
KY
Enumeration date
10/31/2005
Last updated
07/30/2015
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