Individual
DR. TIMOTHY FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
13395 N MARANA MAIN ST, MARANA, AZ 85653-7008
(520) 682-4111
(520) 818-3630
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0320000477
VT
208D00000X
General Practice Physician
Primary
2471
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285404
—
AZ
Enumeration date
03/08/2006
Last updated
08/24/2016
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