Individual
DR. KEITH F FISHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3580 MEMORIAL DR, DECATUR, GA 30032-2723
(404) 284-0701
(404) 284-0703
Mailing address
2283 NORTH DECATUR RD, DECATUR, GA 30030-5423
(770) 314-3756
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1157T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00528844A
—
GA
05
—
00528844B
—
GA
Enumeration date
05/04/2007
Last updated
10/06/2015
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