Michael Nathaniel Fish, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2005017275 Issued in MO

Practice address

516 E. Nizhoni Blvd
Gallup, NM 87301-1337

Phone

(505) 722-1000

Fax

(505) 722-1421

NPI assigned

Feb 27, 2006

Last updated

Nov 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Jackson County Memorial Hospital Authority

  dba Harmon Memorial Hospital

  • Critical Access Hospital
  • Hollis, OK
  • NPI 1295735991
  NPD (past)
• Surgery Center of Springfield Anesthesia

  • Ambulatory Surgical Clinic/Center
  • Springfield, MO
  • NPI 1003980293
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1730155078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10646 S ERIE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377233",
            "telephone_number": "918-269-5123",
            "fax_number": "918-298-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E. NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "MICHAEL",
        "middle_name": "NATHANIEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2005017275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Junior Andres Fernandez Cubilete
• Mary Lee Fertig, RN
• Nancy Magana Fiedacan, RN
• Carrie Field
• Firstline Healthcare and General Services, LLC
• Vanessa M Fisher, RN
• Christopher Fitch, RN
• Kandyse Flanigan, OD
• Brenda Fleishell, RN
• Fletcher John Flieder, RN

• Anesthesiology Physician in Gallup, NM
• Providers in Gallup, NM by specialty
• Anesthesiology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.