Provider Demographics
NPI:1023196755
Name:FISHER, ARTHUR D (OD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:D
Last Name:FISHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12209 LEIGHTON CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-844-7828
Mailing Address - Fax:
Practice Address - Street 1:350 E NEW YORK ST
Practice Address - Street 2:SUITE 250
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2036
Practice Address - Country:US
Practice Address - Phone:317-634-8617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001863152W00000X
IN18001863B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INV09092Medicare UPIN
IN235770Medicare ID - Type Unspecified