MEDICARE: SUZANNE FISHER

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
1	207Q00000X	Family Medicine Physician	53-85142-011	KS

General Provider Information

NPI Number	:	1790636462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE FISHER

Provider Business Mailing Address
First Line	:	2230 N RIDGE RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 N RIDGE RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1053
Country	:	US
Telephone Number	:	316-448-8339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “ SUZANNE FISHER ” Practice Location

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