Individual
MR. LARRY P FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17021 N JOSHUA TREE CT, SUN CITY, AZ 85373-1816
(623) 363-5618
Mailing address
17021 N JOSHUA TREE CT, SUN CITY, AZ 85373-1816
(623) 363-5618
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
367
AK
363AM0700X
Medical Physician Assistant
Primary
4895
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
367
STATE LICENSE #
AK
01
—
4895
STATE OF ARIZONA
AZ
Enumeration date
01/15/2007
Last updated
05/04/2015
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