Gary Michael Fisher Sr., DC
Individual provider Active NPI Chiropractor · Tell City, IN
NPI 1487715652 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487715652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001114A (IN)
- Practice address
- 807 12TH St
Tell City, IN 47586 - Phone
- (812) 547-7632
- Fax
- (812) 547-8990
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08001114A | IN | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001114A | IN | Yes |
Addresses
Primary practice location
807 12TH St
Tell City, IN 47586
Mailing address
807 12TH St
Tell City, IN 47586
Phone (812) 547-7632
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000042703 | Other | IN | BLUE CROSS |
Other providers in Tell City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.