Healthcare Provider Details

I. General information

NPI: 1306333414
Provider Name (Legal Business Name): CHRISTOPHER FISHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15112 TRADITIONS BLVD STE A
EDMOND OK
73013-1182
US

IV. Provider business mailing address

5601 NW 72ND ST STE 245
WARR ACRES OK
73132-5948
US

V. Phone/Fax

Practice location:
  • Phone: 405-289-0483
  • Fax: 405-266-6609
Mailing address:
  • Phone: 405-289-0483
  • Fax: 405-266-6609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34007
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34007
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number34007
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: