Provider Demographics
NPI:1487940268
Name:OUR FAMILY DOCTOR, PLLC
Entity type:Organization
Organization Name:OUR FAMILY DOCTOR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-252-2515
Mailing Address - Street 1:43 OAKLAND RD.
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4807
Mailing Address - Country:US
Mailing Address - Phone:828-252-2515
Mailing Address - Fax:828-252-2555
Practice Address - Street 1:43 OAKLAND RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4807
Practice Address - Country:US
Practice Address - Phone:828-252-2515
Practice Address - Fax:828-252-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890253AMedicaid