Provider Demographics
NPI:1487982534
Name:DESERT SURGICAL ASSOCIATES FISHER PLLC
Entity type:Organization
Organization Name:DESERT SURGICAL ASSOCIATES FISHER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-369-7152
Mailing Address - Street 1:3131 LA CANADA ST STE 217
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2579
Mailing Address - Country:US
Mailing Address - Phone:702-369-7152
Mailing Address - Fax:702-369-7153
Practice Address - Street 1:3131 LA CANADA ST STE 217
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2579
Practice Address - Country:US
Practice Address - Phone:702-369-7152
Practice Address - Fax:702-369-7153
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESERT SURGICAL ASSOCIATES FISHER PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-01
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCZ423AMedicare PIN