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NPI Code Detail

MEDICARE: FISCHER LASER EYE CENTER LLC

MEDICARE: FISCHER LASER EYE CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WC0802XCorneal and Contact Management Optometrist5545930MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C03116OTHERMNMEDICARE PTAN
2CJ8506OTHERMNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558310623
Entity Type Code : Organization
Provider Name (Legal Business Name) : FISCHER LASER EYE CENTER LLC
Provider Business Mailing Address
First Line : 1801 19TH AVE SW
Second Line :
City : WILLMAR
State : MN
Zip : 56201-4946
Country : US
Telephone Number : 320-235-2020
Fax Number : 320-214-5761
Provider Business Practice Location Address
First Line : 1801 19TH AVE SW
Second Line :
City : WILLMAR
State : MN
Zip : 56201-4946
Country : US
Telephone Number : 320-235-2020
Fax Number : 320-214-5761
Authorized Official
Title or Position : OWNER/SURGEON
Name : MR. JEFFREY L FISCHER
Credential : M.D.
Telephone Number : 320-235-2020
Provider Enumeration Date : 05/08/2006
Last Update Date : 11/25/2014

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Directions to “FISCHER LASER EYE CENTER LLC ” Practice Location

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