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Individual
JON TODD FITZGERALD
Active
Individual
JON TODD FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00248
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054399002
BLUE CROSS
OR
05
—
067533
—
OR
01
—
3008597-02
HMOO
OR
01
—
F627
HEALTHNET
OR
Enumeration date
08/19/2005
Last updated
12/09/2009
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