Healthcare Provider Details

I. General information

NPI: 1811970957
Provider Name (Legal Business Name): MR. KIRK J FISCHESSER
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 S MIAMI AVE
CLEVES OH
45002-1216
US

IV. Provider business mailing address

9123 BREHM RD
CINCINNATI OH
45252-2603
US

V. Phone/Fax

Practice location:
  • Phone: 513-941-0428
  • Fax:
Mailing address:
  • Phone: 513-385-6293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-3-16034
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number03-3-16034
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number03-3-16034
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-3-16034
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number03-3-16034
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: