| Timothy M. Fisher, D.o., P.c. | |
|
140 Vo Tech Dr Suite 6 Mc Minnville TN 37110-1329 | |
| (931) 473-4441 | |
| (931) 473-5031 |
| Full Name | Timothy M. Fisher, D.o., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 140 Vo Tech Dr, Mc Minnville, Tennessee |
| Authorized Official Name and Position | Timothy Mark Fisher (OWNER) |
| Authorized Official Contact | 9314734441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy M. Fisher, D.o., P.c. 140 Vo Tech Dr Suite 6 Mc Minnville TN 37110-1329 Ph: (931) 473-4441 | Timothy M. Fisher, D.o., P.c. 140 Vo Tech Dr Suite 6 Mc Minnville TN 37110-1329 Ph: (931) 473-4441 |
| NPI Number | 1376677070 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6709802606 |
|---|---|
| Medicare Enrollment ID | O20051020000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376677070 | NPI | - | NPPES |
| 3374306 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO0000000851 (Tennessee) | Primary |
| Provider Name | Timothy M Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710920467 PECOS PAC ID: 1951327865 Enrollment ID: I20130311000365 |
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