Fitzwater, Larry L

Fitzwater, Larry L is an individual health care provider with primary practice located at #1 Healthcare Drive , Philippi WV 26416. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fitzwater, Larry L can be contacted via phone (304) 457-1760.

Contact Information

Primary practice address
#1 Healthcare Drive Philippi WV 26416
Phone: (304) 457-1760
Fax: (304) 457-1516
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 318 West Virginia

Profile Details

NPI number 1528116662
LBN Legal business name Fitzwater, Larry L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528116662 NPPES
West Virginia Other 318 LICENSE

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