Provider Demographics
NPI:1073583720
Name:FISHER, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461
Mailing Address - Country:US
Mailing Address - Phone:973-875-3646
Mailing Address - Fax:973-875-2021
Practice Address - Street 1:16 E MAIN ST
Practice Address - Street 2:JOHN F FISHER MD PA
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461
Practice Address - Country:US
Practice Address - Phone:973-875-3646
Practice Address - Fax:973-875-2021
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04056400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1391208Medicaid
NJ1391208Medicaid
D96593Medicare UPIN