Individual
DR. THOMAS MARK FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
42 S BROADWAY AVE, BURNS, OR 97720-2014
(541) 573-7988
(888) 371-1993
Mailing address
42 S BROADWAY AVE, BURNS, OR 97720-2014
(541) 573-7988
(888) 371-1993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16856
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009972
—
OR
01
—
838331002
REGENCE BLUE CROSS
OR
01
—
P00174380
RAILROAD MEDICARE
OR
01
—
R151766
MEDICARE PTAN
OR
Enumeration date
07/20/2006
Last updated
12/04/2020
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