Organization
F. B. FITTS JR., M.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK B. FITTS JR. MD (PRESIDENT)
(208) 420-8991
Entity
Organization
Contact information
Practice address
1344 HILAND AVE, BURLEY, ID 83318-1564
(208) 678-1138
Mailing address
PO BOX 1886, TWIN FALLS, ID 83303-1886
(208) 736-0887
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010155405
REGENCE
ID
05
—
807411600
—
ID
01
—
8M816
BLUE CROSS
ID
Enumeration date
05/19/2006
Last updated
07/24/2013
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