JOHN A FETCHERO JR D O P A (NPI# 1457397499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457397499 |
| Entity Type | Organization |
| Organization Name | JOHN A FETCHERO JR D O P A |
| Practice Address |
1542 Kingsley Ave Ste 140 Orange Park FL 32073-4547 |
| Mailing Address |
2862 Country Club Blvd Orange Park FL 32073-5728 |
| Practice Telephone | 9042783820 |
| Practice Fax Number | 9042783849 |
| Mailing Telephone | 9042783820 |
| Mailing Fax Number | 9042783849 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-09-30 |
| Authorized Official Name | JOHN ANTHONY FETCHERO JR. (PRESIDENT) |
| Authorized Official Telephone | 9042783820 |
| Authorized Official Credential | D O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 048447400 | 05 |
| Street Address |
1542 KINGSLEY AVE STE 140 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558322610 | David Craig Pearson | Otolaryngology | 1835 East West Parkway, Suite 19, Orange Park, FL 32003 | 2006-03-29 |
| 1780739482 | Pearson Facial Plastic Surgery Pa | Otolaryngology | 1835 East West Parkway, Suite 19, Orange Park, FL 32003 | 2007-01-24 |
| 1912912106 | J D Ruggiero Md Pllc | Otolaryngology | 2035 Professional Center Dr, Suite A, Orange Park, FL 32073-4492 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740832799 | Aspire Allergy & Sinus of Florida Pllc | Otolaryngology | 31800 Us Highway 19 N, Palm Harbor, FL 34684-3713 | 2019-07-10 |
| 1376970731 | Accent Physician Specialists, P.a. | Otolaryngology | 438 Sw Perimeter Gln, Suite 100, Lake City, FL 32025-0497 | 2013-10-01 |
| 1306190889 | Elliott Solomon | Otolaryngology | 4381 White Cedar Lane, Delray Beach, FL 33445 | 2012-11-05 |
| 1992036933 | Don N. Lerner, Md, P.a. | Otolaryngology | 836 Prudential Dr Ste 1802, Suite 1802, Jacksonville, FL 32207-8345 | 2010-01-14 |
| 1710143987 | Broward Head Neck and Facial Plastic Surgery Pa | Otolaryngology | 2671 Riviera Mnr, Weston, FL 33332-3422 | 2008-08-06 |
| 1356517767 | Jeremy Boyd White | Otolaryngology | 20950 Ne 27th Ct Ste 302, Arc Plastic Surgery, Aventura, FL 33180-1232 | 2008-05-06 |
| 1073709127 | Burger Zapf | Otolaryngology | 411 Walnut St, Green Cove Springs, FL 32043-3443 | 2007-09-22 |
| 1639360258 | Beaches Facial and Nasal Surgery Center | Otolaryngology | 1361 13th Ave S Ste 125, Jacksonville Beach, FL 32250-3260 | 2007-08-08 |
| 1851509889 | Kapil Saigal | Otolaryngology | 1035 N Orlando Ave Ste 205, Winter Park, FL 32789-2213 | 2007-05-21 |
| 1790853091 | Linda J Gardiner | Otolaryngology | 9771 Cypress Lake Dr, Fort Myers, FL 33919-6063 | 2006-12-04 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.