MEDICARE: CARY ARDIS FISHER MD

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	207Q00000X	Family Medicine Physician	17279	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	:	1568444750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARY ARDIS FISHER MD

Provider Business Mailing Address
First Line	:	7301 N COMANCHE AVE
Second Line	:	SUITE B
City	:	WARR ACRES
State	:	OK
Zip	:	73132-6636
Country	:	US
Telephone Number	:	405-728-2100
Fax Number	:	405-728-2244

Provider Business Practice Location Address
First Line	:	7301 N COMANCHE AVE
Second Line	:	SUITE B
City	:	WARR ACRES
State	:	OK
Zip	:	73132-6636
Country	:	US
Telephone Number	:	405-728-2100
Fax Number	:	405-728-2244

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	08/18/2011

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Directions to “ CARY ARDIS FISHER MD” Practice Location

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