person
Jonathan Donald Fisher, DPM
Foot & Ankle Surgery Podiatrist in Ponderay, Idaho
NPI 1891969606

Jonathan Donald Fisher is a Foot & Ankle Surgery Podiatrist based in Ponderay, ID and is specialized in Foot & Ankle Surgery. Jonathan Donald Fisher practices in Ponderay, ID and has the professional credentials of DPM. The NPI Number for Jonathan Donald Fisher is 1891969606 and holds a License No. P-198 (Idaho).

The current practice location address for Jonathan Donald Fisher is 30544 Highway 200, Ponderay, ID and can be reached out via phone at 208-265-9817 and via fax at 208-265-4533.

Location: 30544 Highway 200, Ponderay, ID, 83852-5005
person
Provider Profile Details
NPI Number
1891969606
Provider Name
Jonathan Donald Fisher
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
30544 Highway 200, Ponderay, ID, 83852-5005
Phone Number
208-265-9817
Fax Number
208-265-4533
Provider Enumeration Date
04/14/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P2448 01 ID BLUE CROSS
808011000 05 ID
1100300 01 ID MEDICARE
000010167109 01 ID REGENCE BLUE SHIELD
P00638389 01 ID RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
30544 Highway 200
City
State
Zip
83852-5005
Phone Number
208-265-9817
Fax Number
208-265-4533
person
Provider Business Mailing Address Details
Address
30544 Highway 200
City
State
Zip
83852-5005
Phone Number
208-265-9817
Fax Number
208-265-4533
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
P-198 (Idaho)
Definition
Definition to come...
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