Healthcare Provider Details

I. General information

NPI: 1578764502
Provider Name (Legal Business Name): FITZPATRICK EYE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 S 73RD ST SUITE 402
OMAHA NE
68124-2396
US

IV. Provider business mailing address

2420 S 73RD ST SUITE 402
OMAHA NE
68124-2396
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-7926
  • Fax:
Mailing address:
  • Phone: 402-397-7926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number22116
License Number StateNE

VIII. Authorized Official

Name: DR. ANNE M FITZPATRICK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-397-1654