MEDICARE: DR. HARRY CHAYNE FISHER D.O.

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	208600000X	Surgery Physician	3189	OK
2	207P00000X	Emergency Medicine Physician	3189	OK

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	:	1174556054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY CHAYNE FISHER D.O.

Provider Business Mailing Address
First Line	:	2401 W WRANGLER BLVD
Second Line	:
City	:	SEMINOLE
State	:	OK
Zip	:	74868-1917
Country	:	US
Telephone Number	:	405-303-4611
Fax Number	:	405-303-4617

Provider Business Practice Location Address
First Line	:	919 JEFFERSON ST
Second Line	:
City	:	SEMINOLE
State	:	OK
Zip	:	74868-1900
Country	:	US
Telephone Number	:	405-382-0585
Fax Number	:	405-382-5940

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	05/25/2022

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