IndividualActive
Jonathan Fisher, DPM
NPI 1891969606 · Foot & Ankle Surgery Podiatrist · Ponderay, ID
Provider details
- NPI number
- 1891969606
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- License
- P-198 (ID)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Practice location
30544 Highway 200
Suite 102
Ponderay, ID 83852-5005
Phone: (208) 265-9817
Fax: (208) 265-4533
Approximate (ZIP-level) locationGet directions
Mailing address
30544 Highway 200
Ponderay, ID 83852-5005
Registry dates
- Enumerated
- 2008-04-14
- Last updated
- 2021-06-23
- Certified
- 2021-06-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.