Provider Demographics
NPI:1285641860
Name:FISCHER, TIMOTHY H (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:H
Last Name:FISCHER
Suffix:
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 1:2000 Q ST
Mailing Address - Street 2:STE 500
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3610
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:7121 STEPHANIE LN
Practice Address - Street 2:SUITE 105
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5359
Practice Address - Country:US
Practice Address - Phone:402-484-8383
Practice Address - Fax:402-484-7043
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1388OtherMIDLANDS CHOICE
NE470780857 11Medicaid
NE31881OtherBCBS
NE01-00803OtherUHC
NE01-00803OtherUHC
1388OtherMIDLANDS CHOICE
278877Medicare PIN