Individual
IZAAK D FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1830 BLAKE AVE, STE 206, GLENWOOD SPRINGS, CO 81601-4227
(970) 384-7140
Mailing address
1830 BLAKE AVE, STE 206, GLENWOOD SPRINGS, CO 81601-4227
(970) 384-7140
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-2255
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36780758
—
CO
Enumeration date
09/20/2006
Last updated
06/23/2015
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