Dr Dale T Fetroe, MD is a
Family Medicine physician based in Connell, Washington. Dr Dale T Fetroe is licensed to practice in Washington (license number MD00018950) and his current practice location is 1301 Ephrata, C/o Coyote Ridge Correction Center, Connell, Washington. He can be reached at his office (for appointments etc.) via phone at
(509) 543-5903.
NPI number for Dr Dale T Fetroe is 1124025721 and his current mailing address is 1301 Ephrata, C/o Coyote Ridge Correction Center, Connell, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1124025721.
Physician's Profile
| Full Name | Dr Dale T Fetroe |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 1301 Ephrata, Connell, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124025721
- Provider Enumeration Date: 06/28/2005
- Last Update Date: 03/22/2011
Medical Identifiers
Medical identifiers for Dr Dale T Fetroe such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124025721 | NPI | - | NPPES |
| 080173711 | Other | WA | RAILROAD MEDICARE |
| 239467 | Medicaid | OR | |
| 1111855 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | MD00018950 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Dale T Fetroe is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Dale T Fetroe, MD
1301 Ephrata, C/o Coyote Ridge Correction Center,
Connell, WA 99326
Ph: (509) 543-5903 | Dr Dale T Fetroe, MD
1301 Ephrata, C/o Coyote Ridge Correction Center,
Connell, WA 99326
Ph: (509) 543-5903 |
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