Healthcare Provider Details

I. General information

NPI: 1558648071
Provider Name (Legal Business Name): ORNA FISHER, MD, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5380 S RAINBOW BLVD SUITE 210
LAS VEGAS NV
89118-1877
US

IV. Provider business mailing address

5380 S RAINBOW BLVD SUITE 210
LAS VEGAS NV
89118-1877
US

V. Phone/Fax

Practice location:
  • Phone: 702-751-2699
  • Fax: 866-852-5664
Mailing address:
  • Phone: 702-751-2699
  • Fax: 866-852-5664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number13407
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number13407
License Number StateNV

VIII. Authorized Official

Name: DR. ORNA FISHER
Title or Position: OWNER/PRACTITIONER
Credential: MD
Phone: 702-751-2699