Provider Demographics
NPI:1821032509
Name:FISHER, TASHA ANN (PT)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:ANN
Last Name:FISHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0778
Mailing Address - Country:US
Mailing Address - Phone:205-786-0315
Mailing Address - Fax:
Practice Address - Street 1:924 FULTON AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1229
Practice Address - Country:US
Practice Address - Phone:205-786-0315
Practice Address - Fax:205-788-2663
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051526344OtherBLUE CROSS
AL000083114Medicaid
MS00124708OtherMISSISIPPI MEDICAID
AL020014611OtherRAILROAD MEDICARE
AL051536567Medicaid
AL000083114OtherBLUE CROSS
AL051002560OtherBLUE CROSS
051536567OtherBLUE CROSS
AL12967OtherHEALTHSPRING OF ALABAMA
AL009977855Medicaid
AL009977845Medicaid
AL051526341OtherBLUE CROSS
AL890014370Medicaid
AL12967OtherHEALTHSPRING OF ALABAMA
AL051536567Medicare PIN
MS00124708OtherMISSISIPPI MEDICAID
AL051536567Medicaid