Individual
DR. RUSSELL W FITZGERALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 PLAZA DR, LIBERAL, KS 67901-2743
(620) 624-5691
(620) 624-3656
Mailing address
2 PLAZA DR, LIBERAL, KS 67901-2743
(620) 624-5691
(620) 624-3656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-27378
KS
207R00000X
Internal Medicine Physician
23365
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101857
BCBS OF KS
KS
Enumeration date
03/01/2006
Last updated
07/09/2007
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