Gary Fisk is a Surgical in Peoria, Illinois. Gary Fisk practices all healthcare services and medical treatments related to Surgical. The NPI Number for Gary Fisk is 1891708491. The last update date is 2007-07-08.
Gary Fisk's current location address is 5405 N Knoxville Ave, Peoria, Illinois. You can contact this provider via phone number 3096914410. The mailing address for Gary Fisk is 5405 N Knoxville Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary Fisk |
|---|---|
| Address | 5405 N Knoxville Ave, Peoria, Illinois |
| Phone Number | 3096914410 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1891708491 |
|---|---|
| Provider Enumeration Date | 2006-08-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5405 N Knoxville Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616145016 |
| Phone Number | 3096914410 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | 85000405 |
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Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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Post Comment/ Review Below
What is the Gary Fisk's 1891708491?
The Gary Fisk's NPI (National Provider Identifier) Number is 1891708491. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Gary Fisk?
The Gary Fisk is situated at 5405 N Knoxville Ave, in the city of Peoria, state of IL, with the zip code 616145016.
What is Gary Fisk's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Gary Fisk is Surgical, and the taxonomy code that classifies this field of practice is 363As0400X.
On what date did the Gary Fisk receive its 1891708491 assignment from the Centers for Medicare & Medicaid Services?
The Gary Fisk was assigned its 1891708491 by the Centers for Medicare & Medicaid Services on 2006-08-14.
When was the information regarding Gary Fisk, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Gary Fisk, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
NPI Number: 1720081763
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