Provider Demographics
NPI:1215023460
Name:FISHER, TRAVIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:J
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:PSYCHIATRIC HOSPITALIST
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6850
Mailing Address - Fax:414-805-6851
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:PSYCHIATRIC HOSPITALIST
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6850
Practice Address - Fax:414-805-6851
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI515322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1215023460Medicaid
WI35357400Medicaid
WI680861019Medicare PIN
WI1215023460Medicaid