Organization
DOUGLAS FITZWATER
Active
Other names
Caruthersville Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS S FITZWATER MD (MD OWNER)
(573) 333-0033
Entity
Organization
Contact information
Practice address
412 WARD AVE, CARUTHERSVILLE, MO 63830-1451
(573) 333-0033
(573) 333-2522
Mailing address
PO BOX 817, CAPE GIRARDEAU, MO 63702-0817
(573) 335-4715
(573) 334-2303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
596113605
—
MO
01
—
7158
BCBS
MO
Enumeration date
10/28/2005
Last updated
02/12/2009
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