Provider Demographics
NPI:1528046356
Name:FISCHER, DENNIS C (PA-C)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:C
Last Name:FISCHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BUNKER LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-8956
Mailing Address - Country:US
Mailing Address - Phone:702-810-7524
Mailing Address - Fax:
Practice Address - Street 1:503 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5327
Practice Address - Country:US
Practice Address - Phone:318-329-3475
Practice Address - Fax:318-329-3719
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV722363A00000X
NVPA722363A00000X
LAPA767363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002402171Medicaid
NV002402171Medicaid
32643Medicare UPIN