Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD16765 | RI |
N | 2086S0105X | Surgery of the Hand | 60290 | AZ |
NPI | 1093126807 |
---|---|
Provider Name | Shannon Fitzpatrick |
First Address | Tucson, AZ 85712-1256 |
Second Address | Tucson, AZ 85712-1256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2014 |
Last Update Date | 12/10/2021 |