MEDICARE: DR. KENNETH ALLEN FISCHER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	04-28013	KS
2	2086S0105X	Surgery of the Hand (Surgery) Physician	04-28013	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134131402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH ALLEN FISCHER M.D.

Provider Business Mailing Address
First Line	:	1419 WESTPORT LANDING PL
Second Line	:	SUITE 101
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2906
Country	:	US
Telephone Number	:	785-776-7500
Fax Number	:	785-770-8558

Provider Business Practice Location Address
First Line	:	1419 WESTPORT LANDING PL
Second Line	:	SUITE 101
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2906
Country	:	US
Telephone Number	:	785-776-7500
Fax Number	:	785-770-8558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	10/30/2012

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