Individual
JOHN L FISHER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
3701 LANSDOWNE DRIVE, ASHLAND, KY 41102
(606) 324-3005
(606) 329-1530
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
131
KY
106H00000X
Marriage & Family Therapist
Primary
0172
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365057
ANTHEM BCBS
—
01
—
10980
CHA
—
01
—
11662893
CAQH
—
01
—
610661987
CIGNA
—
05
—
7100283060
—
KY
Enumeration date
07/14/2006
Last updated
11/06/2014
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