Basic Information
| Provider Information | |||||||||
| NPI: | 1598716565 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FETTER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MONROE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 VETERANS DR | ||||||||
| Address2: | VA MEDICAL CENTER (116A) | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405022235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592334511 | ||||||||
| FaxNumber: | 8592814803 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 VETERANS DR | ||||||||
| Address2: | VA MEDICAL CENTER (116A) | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405022235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592334511 | ||||||||
| FaxNumber: | 8592814803 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 23382 | KY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.