Provider Demographics
NPI:1144309345
Name:FISCHER, DONALD E JR (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:FISCHER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W RAILWAY ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3177
Mailing Address - Country:US
Mailing Address - Phone:308-632-0800
Mailing Address - Fax:308-632-0800
Practice Address - Street 1:115 W RAILWAY ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3177
Practice Address - Country:US
Practice Address - Phone:308-632-0800
Practice Address - Fax:308-632-0800
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE118652084F0202X
WY6520A2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025341300Medicaid
NE10025341300Medicaid
NEB67769Medicare UPIN