Individual
DR. LARRY BRENT FISHBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
220 W PERRY ST, PAULDING, OH 45879-1452
(419) 399-4771
Mailing address
1032 W WAYNE ST, PAULDING, OH 45879-1545
(419) 399-2045
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-001653F
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056353
—
OH
Enumeration date
05/11/2006
Last updated
01/17/2008
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