Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 34-00-5989F | OH |
NPI | 1184685273 |
---|---|
Provider Name | Lenora A Fitton |
First Address | Washington Court House, OH 43160-1726 |
Second Address | Wilmington, OH 45177-2171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 01/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0216368 | (05) | OH |
H49535 | (02) | OH |