| Michael R Fisher DO, PSC | |
|
44 Mccoy Rd Suite 103 Madisonville KY 42431-2963 | |
| (270) 824-9222 | |
| (270) 824-8088 |
| Full Name | Michael R Fisher DO, PSC |
|---|---|
| Speciality | Internal Medicine |
| Location | 44 Mccoy Rd, Madisonville, Kentucky |
| Authorized Official Name and Position | Michael R. Fisher (PRESIDENT) |
| Authorized Official Contact | 2708249222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Fisher DO, PSC Po Box 469 Madisonville KY 42431-0009 Ph: (270) 924-9222 | Michael R Fisher DO, PSC 44 Mccoy Rd Suite 103 Madisonville KY 42431-2963 Ph: (270) 824-9222 |
| NPI Number | 1548258395 |
|---|---|
| Provider Enumeration Date | 10/06/2005 |
| Last Update Date | 10/09/2012 |
| Medicare PECOS PAC ID | 0042236929 |
|---|---|
| Medicare Enrollment ID | O20051020000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548258395 | NPI | - | NPPES |
| 200377020 | Medicaid | IN | |
| 65936205 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
| Provider Name | Michael R Fisher |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255329090 PECOS PAC ID: 8527073170 Enrollment ID: I20100113000681 |
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