Provider Demographics
NPI:1427106152
Name:FISHER & HINNANT PROSTHETICS AND ORTHOTICS, INC.
Entity type:Organization
Organization Name:FISHER & HINNANT PROSTHETICS AND ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HINNANT
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:270-769-2053
Mailing Address - Street 1:950 N MULBERRY ST
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3612
Mailing Address - Country:US
Mailing Address - Phone:270-769-2053
Mailing Address - Fax:270-737-5020
Practice Address - Street 1:950 N MULBERRY ST
Practice Address - Street 2:SUITE 100-A
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-3612
Practice Address - Country:US
Practice Address - Phone:270-769-2053
Practice Address - Fax:270-737-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY020097001OtherPTAN
KY90100470Medicaid