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General NPI Number Information
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NPI Number | 1598881039
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Entity Type | Individual
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Provider Name | DESMOND LAWRENCE FISCHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1313 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2934
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Country | US
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Telephone | 423-892-9729
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Fax | 423-648-9040
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Provider Business Mailing Address
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Address Line | PO BOX 21891
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City | CHATTANOOGA
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State | TN
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Zip | 37424-0891
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Country | US
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Telephone | 423-892-9729
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Fax | 423-648-9040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD0000018485
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License Number State | TN
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