MEDICARE: MR. FRANKLIN S FISHER MPT, LAT, ATC

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	2251X0800X	Orthopedic Physical Therapist	8343	NC

General Provider Information

NPI Number	:	1518038322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANKLIN S FISHER MPT, LAT, ATC

Provider Business Mailing Address
First Line	:	2453 GUM BRANCH RD STE 600
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-4008
Country	:	US
Telephone Number	:	910-353-9800
Fax Number	:	910-455-2083

Provider Business Practice Location Address
First Line	:	2453 GUM BRANCH RD STE 600
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-4008
Country	:	US
Telephone Number	:	910-353-9800
Fax Number	:	910-455-2083

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	02/28/2023

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