Provider Demographics
NPI:1427189497
Name:FISCHER, KATHLEEN MAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MAE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 VETERANS PKWY
Mailing Address - Street 2:SUITE1500
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-7797
Mailing Address - Country:US
Mailing Address - Phone:812-280-7500
Mailing Address - Fax:812-280-8016
Practice Address - Street 1:1370 VETERANS PKWY
Practice Address - Street 2:SUITE1500
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-7797
Practice Address - Country:US
Practice Address - Phone:812-280-7500
Practice Address - Fax:812-280-8016
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010779A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice