Healthcare Provider Details

I. General information

NPI: 1346354750
Provider Name (Legal Business Name): JEFFREY FISCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4664
US

IV. Provider business mailing address

2950 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4664
US

V. Phone/Fax

Practice location:
  • Phone: 702-722-2229
  • Fax: 702-778-7672
Mailing address:
  • Phone: 702-722-2229
  • Fax: 702-778-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number9113
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: