1033319132 NPI number — RICHARD H FITTON JR MD INC

Table of content: (NPI 1033319132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033319132 NPI number — RICHARD H FITTON JR MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD H FITTON JR MD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1033319132
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1030 PRESIDENT AVE RM 124
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02720-5923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-676-3411
Provider Business Mailing Address Fax Number:
508-235-6665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1030 PRESIDENT AVE RM 124
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02720-5923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-676-3411
Provider Business Practice Location Address Fax Number:
508-235-6665
Provider Enumeration Date:
07/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FITTON
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
HOWORTH
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
508-676-3411

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  24500 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 739115 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: M11520 . This is a "BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 23591 . This is a "BOSTON MEDICAL CENTER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MB6198 . This is a "HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: RF00406 . This is a "EDS MEDICAID" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: B20429401 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007923 . This is a "NEIGHBORHOOD HEALTHPLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1001000 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 19282 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4189 . This is a "BCBS RHODE ISLAND" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 84875 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 889509 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9736743 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: S006975 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".




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