Provider Demographics
NPI:1811970957
Name:FISCHESSER, KIRK J
Entity type:Individual
Prefix:MR
First Name:KIRK
Middle Name:J
Last Name:FISCHESSER
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 1:9123 BREHM RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45252-2603
Mailing Address - Country:US
Mailing Address - Phone:513-385-6293
Mailing Address - Fax:
Practice Address - Street 1:45 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:CLEVES
Practice Address - State:OH
Practice Address - Zip Code:45002-1216
Practice Address - Country:US
Practice Address - Phone:513-941-0428
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-16034183500000X, 1835N0905X, 1835N1003X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N0905XPharmacy Service ProvidersPharmacistNuclear
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric