MEDICARE: DR. JOHN SHERWOOD FIFER JR. 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	207X00000X	Orthopaedic Surgery Physician	ME41842	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20022162	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1912908823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN SHERWOOD FIFER JR. M.D.

Provider Business Mailing Address
First Line	:	8350 RIVERWALK PARK BLVD
Second Line	:	SUITE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33919-8759
Country	:	US
Telephone Number	:	239-482-5399
Fax Number	:	239-482-5153

Provider Business Practice Location Address
First Line	:	8350 RIVERWALK PARK BLVD
Second Line	:	SUITE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33919-8759
Country	:	US
Telephone Number	:	239-482-5399
Fax Number	:	239-482-5153

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	05/12/2014

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