Individual
TIMOTHY J FITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
450 S WILLARD ST, COTTONWOOD, AZ 86326-6743
(928) 649-7960
(928) 634-1117
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2922
(928) 214-2932
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6076
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158628
—
AZ
Enumeration date
06/17/2005
Last updated
04/11/2019
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