Provider Demographics
NPI:1538531538
Name:CHRISTOPHER FISHER MD LLC
Entity type:Organization
Organization Name:CHRISTOPHER FISHER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER MD
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-556-0519
Mailing Address - Street 1:10124 DESERT WIND DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-6508
Mailing Address - Country:US
Mailing Address - Phone:702-556-0519
Mailing Address - Fax:
Practice Address - Street 1:7140 SMOKE RANCH RD
Practice Address - Street 2:STE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3157
Practice Address - Country:US
Practice Address - Phone:702-556-0519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA SPINE CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13659261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain