Provider Demographics
NPI:1265547210
Name:FISHER, ARTHUR JAMES III (DPM)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:JAMES
Last Name:FISHER
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4541
Mailing Address - Country:US
Mailing Address - Phone:707-443-9860
Mailing Address - Fax:707-443-1299
Practice Address - Street 1:817 HARRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4541
Practice Address - Country:US
Practice Address - Phone:707-445-5493
Practice Address - Fax:707-445-3552
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2216213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E22160Medicaid
CA000E22161Medicaid
CA000E22160Medicaid
CA000E22161Medicaid
CA0910650001Medicare NSC
CA0756480224Medicare NSC
CA000E22161Medicare PIN