Fitzgerald, Izaak D
Fitzgerald, Izaak D is an individual health care provider with primary practice located at 1830 Blake Ave Ste 206, Glenwood Springs CO 81601-4227. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Fitzgerald, Izaak D can be contacted via phone (970) 384-7140.Contact Information
Primary practice address
1830 Blake Ave Ste 206
Glenwood Springs CO 81601-4227
Phone: (970) 384-7140
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA-2255 | Colorado |
Profile Details
| NPI number | 1811095219 |
|---|---|
| LBN Legal business name | Fitzgerald, Izaak D |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jun 23rd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811095219 | NPPES |
| Colorado | MEDICAID | 36780758 |
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