Individual
DR. CASEY JOHN FATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W IRONWOOD DR STE 175, COEUR D ALENE, ID 83814-4401
(208) 625-6309
(208) 625-6310
Mailing address
700 W IRONWOOD DR STE 175, COEUR D ALENE, ID 83814-4401
(208) 625-6309
(208) 625-6310
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M-9034
ID
Other
Enumeration date
08/10/2005
Last updated
04/19/2024
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