Provider Demographics
NPI:1003972993
Name:FISHER, DONNA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:LYNN
Last Name:FISHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 15TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-3300
Mailing Address - Country:US
Mailing Address - Phone:205-345-3452
Mailing Address - Fax:205-345-3659
Practice Address - Street 1:1025 15TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3300
Practice Address - Country:US
Practice Address - Phone:205-345-3452
Practice Address - Fax:205-345-3659
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000092983Medicare ID - Type Unspecified
AL1003972993Medicare PIN
U80395Medicare UPIN