Individual
DR. JOHN RUSSELL FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
133 LITTLE CONESTOGA RD, CHESTER SPRINGS, PA 19425-9562
(610) 458-9800
(610) 458-9806
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG-000898
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG-000898
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39D2059303
CLIA
PA
Enumeration date
06/13/2006
Last updated
06/12/2024
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