Organization
WILLIAM FITZPATRICK, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM FITZPATRICK M.D. (PRESIDENT)
(505) 792-3063
Entity
Organization
Contact information
Practice address
10 COYOTE TRL, CORRALES, NM 87048-7529
(505) 792-3063
(505) 922-6405
Mailing address
10 COYOTE TRL, CORRALES, NM 87048-7529
(505) 792-3063
(505) 922-6405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
97-49
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538267984
NPI TYPE 1
NM
Enumeration date
09/01/2010
Last updated
09/01/2010
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