Fitzgerald, Russell W
Fitzgerald, Russell W is an individual health care provider with primary practice located at 2 Plaza Dr , Liberal KS 67901-2743. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fitzgerald, Russell W can be contacted via phone (620) 624-5691.Contact Information
Primary practice address
2 Plaza Dr
Liberal KS 67901-2743
Phone: (620) 624-5691
Fax: (620) 624-3656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 04-27378 | Kansas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 23365 | Oklahoma |
Profile Details
| NPI number | 1316914120 |
|---|---|
| LBN Legal business name | Fitzgerald, Russell W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Jul 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316914120 | NPPES |
| Kansas | Other | 101857 | BCBS OF KS |
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