| Doctor Name: | MR. KEVIN ROBERT FISCHER |
| NPI Number: | 1053348375 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | |
| Business Practice Address: | 113 Liemanis Ave 16th Mdg Hurlburt Field, FL - 32544 |
| Business Phone Number: | 8508815152 |
| Business Fax Number: | |
| Mailing Address: | 2022 Eagle Ln, NAVARRE |
| State: | FL |
| Postal Code: | 325668376 |
| Phone Number: | 8509398295 |
| Fax Number: | 8508815145 |
| NPI Enumeration Date: | 06/26/2006 |
| NPI Last Update Date: | 12/01/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |