Dr. Jack Mark Fishaut
MD | Pediatrics | Male
Dr. Jack Mark Fishaut, MD is a Friday Harbor, Washington based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Jack Mark Fishaut is
235 Blair Ave, Friday Harbor, Washington - 98250-0796. He can be contacted on phone at
360-370-5971 and fax number 360-370-5980.
Dr. Jack Mark Fishaut is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Jack Mark Fishaut is
1891779195 which was assigned by NPPES on 01 Dec, 2005 and it was last updated on 07 Mar, 2023.
Dr. Jack Mark Fishaut license number is
MD00040965 for Pediatrics (208000000X) in Washington.
Dr. Jack Mark Fishaut is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Jack Mark Fishaut basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Jack Mark Fishaut |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Dr. Jack Mark Fishaut address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 235 Blair Ave
Friday Harbor, WA, 98250-0796
United States |
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| Phone Number : | 360-370-5971 |
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| Fax Number : | 360-370-5980 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1891779195 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 01 Dec, 2005 |
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| Last Updated On : | 07 Mar, 2023 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Jack Mark Fishaut are as mentioned. Primary taxonomy code for Dr. Jack Mark Fishaut, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | MD00040965 | WA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Jack Mark Fishaut such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 361929500 | Other (non-Medicare) | | Park Natl L & L |
| 4952FI | Other (non-Medicare) | | Regence Blue Shield |
| 532300004 | Other (non-Medicare) | | Group Health |
| 8387367 | Other (non-Medicare) | | DSHS Medicaid |
| 8930937 | Other (non-Medicare) | | Crime Victims |
| 912109329 | Other (non-Medicare) | | First Choice |
| 912109329 | Other (non-Medicare) | | Uniform |
| 912109329 | Other (non-Medicare) | | CHPW |
| 912109329 | Other (non-Medicare) | | Premera Blue Cross |
| D78451 | MEDICARE UPIN | | |
| Labor and Industries | Other (non-Medicare) | | 0182789 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 796
Friday Harbor, WA, 98250-0796
United States |
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| Phone Number : | 360-370-5971 |
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| Fax Number : | 360-370-5980 |
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Business Location:
Patients can refer following map for directions to
Dr. Jack Mark Fishaut practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.