Individual
DR. TIMOTHY A FITZGIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
603 N 6TH AVE, DILLON, SC 29536-2503
(843) 774-7336
(843) 774-3745
Mailing address
603 N 6TH AVE, DILLON, SC 29536-2503
(843) 774-7336
(843) 774-3745
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14011
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140118
—
SC
Enumeration date
07/21/2006
Last updated
01/16/2008
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