Healthcare Provider Details

I. General information

NPI: 1285641860
Provider Name (Legal Business Name): TIMOTHY H FISCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7121 STEPHANIE LN SUITE 105
LINCOLN NE
68516-5359
US

IV. Provider business mailing address

2000 Q ST STE 500
LINCOLN NE
68503-3610
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-8383
  • Fax: 402-484-7043
Mailing address:
  • Phone: 402-421-0896
  • Fax: 402-421-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17471
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: