Individual provider · Type 1 NPI

Gary Fisk, PA

Surgical Physician Assistant · Peoria, IL

NPI number 1891708491 Active

Practice location

5405 N Knoxville Ave
Peoria, IL 61614-5016

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X085000405 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1891708491

Gary Fisk, PA's National Provider Identifier is 1891708491, issued on Aug 14, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Peoria, IL. The record was last updated on Jul 8, 2007.