Individual
DR. JAMES P FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD PA
Contact information
Practice address
1414 PARKWAY, SEVIERVILLE, TN 37862-2845
(865) 765-1562
Mailing address
3219 TOPSIDE DR, KODAK, TN 37764-2354
(865) 765-1562
(865) 465-3866
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1530
FL
152W00000X
Optometrist
Primary
2791
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078771000
—
FL
01
—
088
FOPN
FL
01
—
112546
EYEMED
FL
01
—
29254
SPECTERA
FL
01
—
63520
DAVIS VISION
TN
01
—
650844073
VSP
FL
01
—
650844073
BCBSTN
TN
01
—
650844073
SUPERIOR VISION
—
01
—
FE29254
OPTUM VISION SPECTERA
TN
Enumeration date
10/17/2006
Last updated
12/22/2011
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