Individual
DR. MORGAN BRADLEY FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-9000
Mailing address
200 ACADEMY ST NE, GAINESVILLE, GA 30501
(770) 282-8820
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
3573
WV
2085R0202X
Diagnostic Radiology Physician
Primary
97120
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3573
WVU LICENSE
WV
01
—
OS023014
PENNSYLVANIA OSTEOPATHIC LICENSE
PA
Enumeration date
04/23/2018
Last updated
08/15/2024
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