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Individual

MRS. GWYNN FISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3050 RIO DOSA DRIVE, LEXINGTON, KY 40509-1540
(859) 268-6455
(859) 268-6472
Mailing address
3050 RIO DOSA DRIVE, LEXINGTON, KY 40509-1540
(859) 268-6455
(859) 268-6472

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33519
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64040512
KY
Enumeration date
03/13/2007
Last updated
09/12/2008
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