Provider Demographics
NPI:1558620740
Name:FISHER, VALERIE S (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:S
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 480W
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-762-1515
Mailing Address - Fax:270-752-2852
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:SUITE 480W
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-762-1515
Practice Address - Fax:270-752-2852
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY47921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100269200Medicaid
KY7100269200Medicaid