MEDICARE: DR. DAVID KEITH FITZHUGH PHD, AT, PARAMEDIC

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
1	146L00000X	Paramedic	041037	KS
2	2255A2300X	Athletic Trainer	24-00041	KS

General Provider Information

NPI Number	:	1679536635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID KEITH FITZHUGH PHD, AT, PARAMEDIC

Provider Business Mailing Address
First Line	:	600 PARK ST
Second Line	:	CUNNINGHAM HALL 139
City	:	HAYS
State	:	KS
Zip	:	67601-4009
Country	:	US
Telephone Number	:	785-628-4354
Fax Number	:	785-628-4126

Provider Business Practice Location Address
First Line	:	600 PARK ST
Second Line	:	CUNNINGHAM HALL 139
City	:	HAYS
State	:	KS
Zip	:	67601-4009
Country	:	US
Telephone Number	:	785-628-4354
Fax Number	:	785-628-4126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	02/18/2015

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