Fisk, Gary

Fisk, Gary is an individual health care provider with primary practice located at 5405 N Knoxville Ave , Peoria IL 61614-5016. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Fisk, Gary can be contacted via phone (309) 691-4410.

Contact Information

Primary practice address
5405 N Knoxville Ave Peoria IL 61614-5016
Phone: (309) 691-4410
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085000405 Illinois

Profile Details

NPI number 1891708491
LBN Legal business name Fisk, Gary
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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