Individual
PHILIP CLARK FITZPATRICK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 WILLIAM AVE, NORTH PLATTE, NE 69101
(308) 532-3330
(308) 532-3334
Mailing address
801 WILLIAM AVE, NORTH PLATTE, NE 69101-6556
(308) 532-3330
(308) 532-3334
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
21635
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35296
BLUE CROSS BLUE SHIELD
NE
05
—
47084139713
—
NE
Enumeration date
11/01/2006
Last updated
05/22/2018
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