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NPI Code Detail

MEDICARE: DR. SIMON J FISHER MD

MEDICARE: DR. SIMON J FISHER MD
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician9141045-1205UT
2207RE0101XEndocrinology, Diabetes & Metabolism PhysicianTP463KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952327173
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIMON J FISHER MD
Provider Business Mailing Address
First Line : PO BOX 413033
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84141-3033
Country : US
Telephone Number : 801-213-3900
Fax Number :
Provider Business Practice Location Address
First Line : 2195 HARRODSBURG RD STE 125
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3543
Country : US
Telephone Number : 859-323-2232
Fax Number : 859-257-1078
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 10/27/2021

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