Provider Demographics
NPI:1538267984
Name:FITZPATRICK, WILLIAM FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 COYOTE TRL
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-7529
Mailing Address - Country:US
Mailing Address - Phone:505-792-3063
Mailing Address - Fax:505-922-6405
Practice Address - Street 1:10 COYOTE TRL
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-7529
Practice Address - Country:US
Practice Address - Phone:505-792-3063
Practice Address - Fax:505-922-6405
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM97-49207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMF13709Medicare UPIN