1679536635 NPI number — DR. DAVID KEITH FITZHUGH PHD, AT, PARAMEDIC

Table of content: DR. DAVID KEITH FITZHUGH PHD, AT, PARAMEDIC (NPI 1679536635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679536635 NPI number — DR. DAVID KEITH FITZHUGH PHD, AT, PARAMEDIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FITZHUGH
Provider First Name:
DAVID
Provider Middle Name:
KEITH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, AT, PARAMEDIC
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:
1679536635
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 PARK ST
Provider Second Line Business Mailing Address:
CUNNINGHAM HALL 139
Provider Business Mailing Address City Name:
HAYS
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67601-4009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-628-4354
Provider Business Mailing Address Fax Number:
785-628-4126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 PARK ST
Provider Second Line Business Practice Location Address:
CUNNINGHAM HALL 139
Provider Business Practice Location Address City Name:
HAYS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67601-4009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-628-4354
Provider Business Practice Location Address Fax Number:
785-628-4126
Provider Enumeration Date:
04/10/2006

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: 146L00000X , with the licence number:  041037 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2255A2300X , with the licence number: 24-00041 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com