Organization
FITZGERALD FAMILY EYECARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN DRURY FITZGERALD O.D. (PRESIDENT)
(912) 393-0005
Entity
Organization
Contact information
Practice address
1329 OCILLA RD, DOUGLAS, GA 31533-2213
(912) 393-0005
(912) 393-0058
Mailing address
1329 OCILLA RD, DOUGLAS, GA 31533-2213
(912) 393-0005
(912) 393-0058
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002104
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
535526348B
—
GA
Enumeration date
08/10/2006
Last updated
07/29/2022
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