1033319132 NPI number — RICHARD H FITTON JR MD INC

Table of Contents

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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