Provider Demographics
NPI:1104981232
Name:FISHER, JAMES LEE (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LEE
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:140 LACY STREET NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060
Mailing Address - Country:US
Mailing Address - Phone:770-422-1985
Mailing Address - Fax:770-422-2814
Practice Address - Street 1:140 LACY STREET NW
Practice Address - Street 2:SUITE A
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060
Practice Address - Country:US
Practice Address - Phone:770-422-1985
Practice Address - Fax:770-422-2814
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2015-02-03
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Provider Licenses
StateLicense IDTaxonomies
GA025749207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C83805Medicare UPIN