Provider Demographics
NPI:1053504563
Name:DONALD E. FISCHER, MD, PC
Entity Type:Organization
Organization Name:DONALD E. FISCHER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:308-632-0800
Mailing Address - Street 1:115 W RAILWAY ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3177
Mailing Address - Country:US
Mailing Address - Phone:308-632-0800
Mailing Address - Fax:
Practice Address - Street 1:115 W RAILWAY ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3177
Practice Address - Country:US
Practice Address - Phone:308-632-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DONALD E. FISCHER, JR, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099824Medicare PIN