Individual
DR. JULIE ANN FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEADOWS PKWY, VIDALIA, GA 30474-8759
(912) 535-5053
Mailing address
PO BOX 1303, VIDALIA, GA 30475-1303
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301080307
MI
207L00000X
Anesthesiology Physician
Primary
84379
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84379
STATE LICENSE
GA
Enumeration date
10/02/2006
Last updated
04/01/2021
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