Individual
JEREMY GABRIEL FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
979 E 3RD ST STE 300, CHATTANOOGA, TN 37403-2187
(423) 267-0466
(423) 778-5177
Mailing address
979 E 3RD ST STE 300, CHATTANOOGA, TN 37403-2187
(423) 267-0466
(423) 778-5177
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
35.128754
OH
2086S0120X
Pediatric Surgery Physician
Primary
61514
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0292539
—
OH
01
—
H635870
CGS-MEDICARE
OH
05
—
Q060604
—
TN
Enumeration date
04/28/2009
Last updated
09/29/2023
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