Organization
FITZ-GERALD & PERRET CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MACK FITZ-GERALD (ADMINISTRATOR)
(334) 289-1517
Entity
Organization
Contact information
Practice address
203 HWY 80 WEST, DEMOPOLIS, AL 36732
(334) 289-1517
(334) 289-8353
Mailing address
203 HWY 80 WEST, P. O. BOX 935, DEMOPOLIS, AL 36732
(334) 289-1517
(334) 289-8353
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529302040
—
AL
Enumeration date
04/25/2006
Last updated
03/07/2011
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