Organization · NPI-2

William Fitzpatrick, MD, PA

Family Medicine · Corrales, NM

NPI number1386951192
StatusActive
Last updated in NPPESSep 1, 2010

Details

NPI
1386951192
Entity type
Organization (NPI-2)
Legal business name
William Fitzpatrick, MD, PA
Organization subpart
No
Enumeration date
Sep 1, 2010
Last updated
Sep 1, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine97-49NMYes

Practice location

10 Coyote Trl
Corrales, NM 87048-7529

Phone 505-792-3063 · Fax 505-922-6405

Mailing address

10 Coyote Trl
Corrales, NM 87048-7529

Phone 505-792-3063 · Fax 505-922-6405

Authorized official

William Fitzpatrick
President
5057923063

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