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Organization
FISCHBACH FAMILY MEDICINE & OPTHAMOLOGY
Active
Organization
FISCHBACH FAMILY MEDICINE & OPTHAMOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY T FISCHBACH M.D. (OWNER)
(803) 643-3400
Entity
Organization
Contact information
Practice address
721 RICHLAND AVE W, SUITE 200, AIKEN, SC 29801-3831
(803) 643-3400
(803) 643-3440
Mailing address
3772 IVEY LANE, LILBURN, GA 30047-2156
(803) 643-3400
(803) 643-3440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0502521
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107583
—
SC
01
—
GP2515
MEDICAID GROUP NUMBER
SC
Enumeration date
01/24/2007
Last updated
08/22/2020
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