Provider Demographics
NPI:1952372385
Name:FISCHER, DUNCAN KINNEAR (MD PHD)
Entity Type:Individual
Prefix:MR
First Name:DUNCAN
Middle Name:KINNEAR
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-6883
Mailing Address - Country:US
Mailing Address - Phone:325-947-2525
Mailing Address - Fax:325-947-1139
Practice Address - Street 1:3515 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6883
Practice Address - Country:US
Practice Address - Phone:325-947-2525
Practice Address - Fax:325-947-1139
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2372207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110518103Medicaid
TX110518103Medicaid
TX00J32DMedicare ID - Type Unspecified