Provider Demographics
NPI:1336583699
Name:FISHER, ROBERT GENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GENE
Last Name:FISHER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 S HAVANA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4019
Mailing Address - Country:US
Mailing Address - Phone:303-755-1246
Mailing Address - Fax:303-743-1454
Practice Address - Street 1:1155 S. HAVANA
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4019
Practice Address - Country:US
Practice Address - Phone:303-755-1246
Practice Address - Fax:303-743-1454
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist