Caruthersville Clinic
LBN: Douglas Fitzwater
Caruthersville Clinic is an health care organization with primary practice located at 412 Ward Ave , Caruthersville MO 63830-1451. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Douglas Fitzwater can be contacted via phone (573) 333-0033, or through Fitzwater, Douglas S via phone (573) 333-0033.
Contact Information
Primary practice address
412 Ward Ave
Caruthersville MO 63830-1451
Phone: (573) 333-0033
Fax: (573) 333-2522
Website:
Authorized official contact:
Name: Fitzwater, Douglas S Doctor of Medicine (MD)
Phone: (573) 333-0033
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1467442566 |
|---|---|
| LBN Legal business name | Douglas Fitzwater |
| DBA Doing business as | Caruthersville Clinic |
| Authorized official | Fitzwater, Douglas S Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 28th, 2005 |
| Last updated | Feb 12th, 2009 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467442566 | NPPES |
| Missouri | Other | 7158 | BCBS |
| Missouri | MEDICAID | 596113605 | BCBS |
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