Provider Demographics
NPI:1063515518
Name:FLEMING, RICHARD T (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 E CASSIA WAY
Mailing Address - Street 2:#1002
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4617
Mailing Address - Country:US
Mailing Address - Phone:773-531-8069
Mailing Address - Fax:
Practice Address - Street 1:1683 E FLORENCE BLVD
Practice Address - Street 2:SUITE #7 NEXTCARE URGENT CARE
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4812
Practice Address - Country:US
Practice Address - Phone:520-876-0164
Practice Address - Fax:520-876-0801
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ828931Medicaid
AZ828931Medicaid