Organization
DAVID LAUREN FITZGERALD OD PA
Active
Other names
Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L FITZGERALD OD (PRESIDENT)
(252) 756-4204
Entity
Organization
Contact information
Practice address
1227 BRENTWAY AVE., WILLIAMSTON, NC 27892-7569
(252) 792-6611
(252) 799-0797
Mailing address
1227 BRENTWAY AVE., WILLIAMSTON, NC 27892-7569
(252) 792-6611
(252) 799-0797
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0203R
BCBSNC PIN
NC
05
—
890203R
—
NC
Enumeration date
05/30/2006
Last updated
03/09/2010
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