Provider Demographics
NPI:1205946084
Name:FISHER, DONALD L (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-9517
Mailing Address - Country:US
Mailing Address - Phone:330-825-6225
Mailing Address - Fax:
Practice Address - Street 1:1309 NORTON AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-9517
Practice Address - Country:US
Practice Address - Phone:330-825-6225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.057017207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0882639Medicaid
OH0882639Medicaid
OH0715987Medicare ID - Type Unspecified