Fitzgerald, Mary Amanda

Fitzgerald, Mary Amanda is an individual health care provider with primary practice located at 5701 Summerhill Rd , Texarkana TX 75503-1634. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Fitzgerald, Mary Amanda can be contacted via phone (870) 779-2751.

Contact Information

Primary practice address
5701 Summerhill Rd Texarkana TX 75503-1634
Phone: (870) 779-2751
Fax: (054) 456-7651
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X E-6099 Arkansas

Profile Details

NPI number 1730152000
LBN Legal business name Fitzgerald, Mary Amanda
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jun 21st, 2024 - about 6 months 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1730152000 NPPES
Missouri MEDICAID 202875852
Missouri MEDICAID 183760001

Popular Providers