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
795 US HIGHWAY 64 E, PLYMOUTH, NC 27962-9314
(252) 793-2103
(252) 793-5154
Mailing address
795 US HIGHWAY 64 E, PLYMOUTH, NC 27962-9314
(252) 793-2103
(252) 793-5154
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0172V
BCBSNC GROUP NUMBER
NC
05
—
890172V
—
NC
Enumeration date
05/30/2006
Last updated
07/11/2008
Update your record
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