Provider Demographics
NPI:1770945115
Name:FISHER, MADELINE KEYSER (MD)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:KEYSER
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:MARIE
Other - Last Name:KEYSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:211 FOUNTAIN CT STE 120
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2695
Practice Address - Country:US
Practice Address - Phone:859-629-7245
Practice Address - Fax:859-629-7246
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR4115207R00000X, 208000000X
KY53757207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine