Basic Information
Provider Information
NPI: 1063553261
EntityType: 2
ReplacementNPI:  
OrganizationName: HARRY C FISHER D O P C
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 919 JEFFERSON ST
Address2:  
City: SEMINOLE
State: OK
PostalCode: 748683150
CountryCode: US
TelephoneNumber: 4053820585
FaxNumber: 4053825940
Practice Location
Address1: 919 JEFFERSON ST
Address2:  
City: SEMINOLE
State: OK
PostalCode: 748683150
CountryCode: US
TelephoneNumber: 4053820585
FaxNumber: 4053825940
Other Information
ProviderEnumerationDate: 02/09/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FISHER
AuthorizedOfficialFirstName: HARRY
AuthorizedOfficialMiddleName: C
AuthorizedOfficialTitleorPosition: GENERAL SURGEON
AuthorizedOfficialTelephone: 4053820585
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: D O P C
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X3189OKY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home