| Doctor Name: | JONATHAN DONALD FISHER |
| NPI Number: | 1891969606 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | P-198 |
| Business Practice Address: | 30544 Highway 200 Suite 102 Ponderay, ID - 838525005 |
| Business Phone Number: | 2082659817 |
| Business Fax Number: | 2082654533 |
| Mailing Address: | 30544 Highway 200, Suite 102 PONDERAY |
| State: | ID |
| Postal Code: | 838525005 |
| Phone Number: | 2082659817 |
| Fax Number: | 2082654533 |
| NPI Enumeration Date: | 04/14/2008 |
| NPI Last Update Date: | 04/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | P-198 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |