Provider Demographics
NPI:1053305789
Name:FISHER, DANIEL FRANKLIN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FRANKLIN
Last Name:FISHER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:979 E 3RD ST
Mailing Address - Street 2:STE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-267-0466
Mailing Address - Fax:423-778-8212
Practice Address - Street 1:2108 E 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2600
Practice Address - Country:US
Practice Address - Phone:423-267-0466
Practice Address - Fax:423-778-8212
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2019-02-18
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Provider Licenses
StateLicense IDTaxonomies
TNMD9631208600000X, 2086S0129X, 2086S0129X
TN96312086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000402696EMedicaid
2612533 001OtherCIGNA
92964OtherBCBS OF TN
020041408OtherRR MEDICARE
TNQ002544Medicaid
AL009005120Medicaid
1740075OtherUHC
62165877409OtherJDH
1740075OtherUHC
TNQ002544Medicaid
2612533 001OtherCIGNA