Provider Demographics
NPI:1629013677
Name:FISCHER, JOYCE LS (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:LS
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CAYLOR NICKEL SQ
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-2529
Mailing Address - Country:US
Mailing Address - Phone:260-824-3500
Mailing Address - Fax:260-919-3551
Practice Address - Street 1:303 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2503
Practice Address - Country:US
Practice Address - Phone:260-919-3300
Practice Address - Fax:260-919-3563
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034613A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100258720AMedicaid
IN911080YYMedicare PIN
IN100258720AMedicaid