Provider Demographics
NPI:1497828990
Name:ALLISON FISCHER DO PC
Entity Type:Organization
Organization Name:ALLISON FISCHER DO PC
Other - Org Name:MARY ALLISON FISCHER DO
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLSION
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:660-826-2797
Mailing Address - Street 1:1123 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-6103
Mailing Address - Country:US
Mailing Address - Phone:660-826-2797
Mailing Address - Fax:660-826-2365
Practice Address - Street 1:1123 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-6103
Practice Address - Country:US
Practice Address - Phone:660-826-2797
Practice Address - Fax:660-826-2365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5C49207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
107921OtherHEALTH LINK INS
4828112OtherCIGNA HEALTH CARE
13753027OtherBLUECROSSBLUE SHEILD
13753027OtherBLUECROSSBLUE SHEILD
13753027OtherBLUECROSSBLUE SHEILD
4828112OtherCIGNA HEALTH CARE