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General NPI Number Information
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NPI Number | 1215999321
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Entity Type | Individual
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Provider Name | KATHLEEN M FITZGERALD MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 330 S GARDEN WAY SUITE 270
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City | EUGENE
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State | OR
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Zip | 97401-8176
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Country | US
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Telephone | 541-228-3400
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Fax | 541-284-2937
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Provider Business Mailing Address
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Address Line | 330 SOUTH GARDEN WAY SUITE 270
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City | EUGENE
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State | OR
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Zip | 97401
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Country | US
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Telephone | 541-228-3400
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Fax | 541-284-2937
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD17475
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD17475
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License Number State | OR
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