1194719708 NPI number — WILLIAM E FITTS MD

Table of content: WILLIAM E FITTS MD (NPI 1194719708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194719708 NPI number — WILLIAM E FITTS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FITTS
Provider First Name:
WILLIAM
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194719708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
94220 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GOLD BEACH
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97444-7756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-247-3000
Provider Business Mailing Address Fax Number:
541-247-3101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
94244 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GOLD BEACH
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97444-7756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-247-3000
Provider Business Practice Location Address Fax Number:
541-247-3101
Provider Enumeration Date:
09/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  MD125973 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1083656367 . This is a "CURRY MEDICAL CENTER NPI" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 119263 . This is a "CURRY GENERAL HOSPITAL MEDICAID" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 930937095-97415-D008 . This is a "TRICARE / TRIWEST" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 0000ZGBDG . This is a "CURRY GENERAL HOSPITAL PART B" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1487696985 . This is a "CURRY MEDICAL CENTER MEDICARE PART A" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500611991 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1811939093 . This is a "CURRY FAMILY MEDICAL NPI" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1235145624 . This is a "CURRY WOMENS CLINIC NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 381322 . This is a "CURRY GENERAL HOSPITAL PART A" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: R0000ZGBDG . This is a "CURRY WOMENS CLINIC MEDICARE PART B" identifier . This identifiers is of the category "OTHER".
  • Identifier: R0000ZGBDG . This is a "CURRY MEDICAL CENTER MEDICARE PART B" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1192363 . This is a "CURRY MEDICAL CENTER MEDICAID" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 383990 . This is a "CURRY FAMILY MEDICAL MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 520513001 . This is a "BCBS" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 011325 . This is a "CURRY WOMENS CLINIC MEDICAID" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1487696985 . This is a "CURRY GENERAL HOSPITAL NPI" identifier . This identifiers is of the category "OTHER".




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