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NPI Code Detail

MEDICARE: DR. BARRY JASON FISH M.D.

MEDICARE: DR. BARRY JASON FISH 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
1207VX0000XObstetrics Physician35071927OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110791435OTHEROHCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437154770
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARRY JASON FISH M.D.
Provider Business Mailing Address
First Line : 3428 W MARKET ST
Second Line : STE 100
City : FAIRLAWN
State : OH
Zip : 44333-3339
Country : US
Telephone Number : 330-665-8064
Fax Number : 330-665-8069
Provider Business Practice Location Address
First Line : 3428 W MARKET ST
Second Line : STE 100
City : FAIRLAWN
State : OH
Zip : 44333-3339
Country : US
Telephone Number : 330-665-8064
Fax Number : 330-665-8069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 11/09/2007

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