Provider Demographics
NPI:1861002164
Name:FISHER, ROBERT ANDREW
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANDREW
Last Name:FISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71999-0001
Mailing Address - Country:US
Mailing Address - Phone:336-862-0564
Mailing Address - Fax:
Practice Address - Street 1:1100 HENDERSON ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71999-0001
Practice Address - Country:US
Practice Address - Phone:870-230-5426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer