Individual
TIMOTHY MARK FISHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
140 VO TECH DR, SUITE 6, MC MINNVILLE, TN 37110-1329
(931) 473-4441
(931) 473-5031
Mailing address
140 VO TECH DR, SUITE 6, MC MINNVILLE, TN 37110-1329
(931) 473-4441
(931) 473-5031
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
DO0000000851
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3374306
—
TN
01
—
51818
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/13/2006
Last updated
07/08/2007
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