Provider Demographics
NPI:1578611844
Name:RICHARD FIGHTLIN MD
Entity Type:Organization
Organization Name:RICHARD FIGHTLIN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-783-1181
Mailing Address - Street 1:560 W PUTNAM AVE
Mailing Address - Street 2:NO 4
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3269
Mailing Address - Country:US
Mailing Address - Phone:559-782-1807
Mailing Address - Fax:559-782-4614
Practice Address - Street 1:560 W PUTNAM AVE
Practice Address - Street 2:NO 4
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3269
Practice Address - Country:US
Practice Address - Phone:559-782-1807
Practice Address - Fax:559-782-4614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty