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General NPI Number Information
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NPI Number | 1750421855
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Entity Type | Organization
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Legal Business Name | THOMAS FITZPATRICK, MD, PC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8 LIVE OAK CT STE B
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City | MOULTRIE
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State | GA
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Zip | 31768-6783
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Country | US
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Telephone | 229-890-6612
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Fax | 229-890-6621
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Provider Business Mailing Address
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Address Line | 8 LIVE OAK CT STE B
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City | MOULTRIE
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State | GA
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Zip | 31768-6783
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Country | US
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Telephone | 229-890-6612
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Fax | 229-890-6621
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Authorized Official
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Title or Position | PHYSICIAN BILLING COORDINATOR
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Name | AMY MORGAN
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Credential |
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Telephone | 229-985-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 054715
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License Number State | GA
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