Individual
DR. LESLIE M FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 E WEISGARBER RD STE 200, KNOXVILLE, TN 37909
(186) 558-4474
(865) 584-1363
Mailing address
325 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6056
(423) 439-6283
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53803
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031939
—
TN
Enumeration date
04/12/2013
Last updated
07/12/2018
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