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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 10 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 1811095219 NPPES
Colorado MEDICAID 36780758

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