Provider Demographics
NPI:1528685013
Name:FISCHER, LANCE JOHN
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:JOHN
Last Name:FISCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 190TH ST
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-8863
Mailing Address - Country:US
Mailing Address - Phone:712-358-0228
Mailing Address - Fax:
Practice Address - Street 1:1316 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-2019
Practice Address - Country:US
Practice Address - Phone:515-532-9229
Practice Address - Fax:515-532-9321
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist