Provider Demographics
NPI:1295704344
Name:FISHER, THOMAS E (DDS MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:FISHER
Suffix:
Gender:M
Credentials:DDS MD
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 8047
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-8047
Mailing Address - Country:US
Mailing Address - Phone:740-588-9000
Mailing Address - Fax:740-588-9889
Practice Address - Street 1:3983 N POINTE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7361
Practice Address - Country:US
Practice Address - Phone:740-588-9000
Practice Address - Fax:740-588-9889
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300206131223S0112X
OH35079106204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFI4052113Medicare ID - Type Unspecified