Individual
GLENN A. FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(855) 446-5937
(740) 446-5749
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5137
(740) 446-5749
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
16942
WV
207Q00000X
Family Medicine Physician
35.073911
OH
207Q00000X
Family Medicine Physician
Primary
35073911
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007237
ANTHEM BCBS
—
01
—
000000181866
UNISON MEDICAID
OH
01
—
001714098
MOUNTAIN STATE BCBS
—
05
—
0055114000
—
WV
01
—
080107118
RR MEDICARE
—
01
—
2025874
MOLINA MEDICAID
OH
01
—
310917085067
OH MEDICAID CARESOURCE
OH
Enumeration date
05/18/2006
Last updated
04/30/2025
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