Provider Demographics
NPI:1669897500
Name:FISHER, CASEY (DO)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:FISHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 GOLDEN VALLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4475
Mailing Address - Country:US
Mailing Address - Phone:763-233-5755
Mailing Address - Fax:
Practice Address - Street 1:8301 GOLDEN VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4475
Practice Address - Country:US
Practice Address - Phone:763-233-5755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-02
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN64979207YS0123X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery