Healthcare Provider Details

I. General information

NPI: 1710912001
Provider Name (Legal Business Name): WILLIAM D FRITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 HOSPITAL AVE SUITE 311
DU BOIS PA
15801-1462
US

IV. Provider business mailing address

145 HOSPITAL AVE SUITE 311
DU BOIS PA
15801-1462
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-3750
  • Fax: 814-375-9624
Mailing address:
  • Phone: 814-375-3750
  • Fax: 814-375-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD 023826
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: