=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558648071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORNA FISHER, MD, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2011
-----------------------------------------------------
Last Update Date | 11/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5380 S RAINBOW BLVD SUITE 210
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89118-1877
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-751-2699
-----------------------------------------------------
Fax | 866-852-5664
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5380 S RAINBOW BLVD SUITE 210
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89118-1877
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-751-2699
-----------------------------------------------------
Fax | 866-852-5664
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRACTITIONER
-----------------------------------------------------
Name | DR. ORNA FISHER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 702-751-2699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 13407
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | 13407
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------