Provider Demographics
NPI:1245416312
Name:FISCHER, DEREK D (DC)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:D
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 E CHANDLER BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-4605
Mailing Address - Country:US
Mailing Address - Phone:480-460-1399
Mailing Address - Fax:480-460-1880
Practice Address - Street 1:1241 E CHANDLER BLVD STE 122
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-4605
Practice Address - Country:US
Practice Address - Phone:480-460-1399
Practice Address - Fax:480-460-1880
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor