Doctor Name: | JASON FISHER |
NPI Number: | 1720412943 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 28065 |
Business Practice Address: | 701 Hospital Loop # 9000 Fairchild Afb, WA - 990118704 |
Business Phone Number: | 5092745755 |
Business Fax Number: | |
Mailing Address: | 701 Hospital Loop # 9000, FAIRCHILD AFB |
State: | WA |
Postal Code: | 990118704 |
Phone Number: | 5092745755 |
Fax Number: | |
NPI Enumeration Date: | 08/23/2013 |
NPI Last Update Date: | 09/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 28065 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |