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NPI Code Detail

MEDICARE: DR. JERRY WILLIAM FITZ MD

MEDICARE: DR. JERRY WILLIAM FITZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0401XAddiction Medicine (Family Medicine) Physician22954AZ

General Provider Information

NPI Number : 1134250228
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JERRY WILLIAM FITZ MD
Provider Business Mailing Address
First Line : 1000 E VIA ENTRADA
Second Line :
City : TUCSON
State : AZ
Zip : 85718-4740
Country : US
Telephone Number : 520-624-4000
Fax Number : 520-825-3523
Provider Business Practice Location Address
First Line : 39580 S LAGO DEL ORO PKWY
Second Line :
City : TUCSON
State : AZ
Zip : 85739-1091
Country : US
Telephone Number : 520-624-4000
Fax Number : 520-825-3523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JERRY WILLIAM FITZ MD” Practice Location

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