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Individual

DR. CHARLES RAY FISHER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236
(210) 671-4516
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 671-4516

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30120-020
WI
207Q00000X
Family Medicine Physician
N5675
TX
2083A0100X
Aerospace Medicine Physician
30120-020
WI
2083A0100X
Aerospace Medicine Physician
Primary
N5675
TX
2083X0100X
Occupational Medicine Physician
30120-020
WI
2083X0100X
Occupational Medicine Physician
N5675
TX

Other

Enumeration date
01/24/2006
Last updated
10/16/2019
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