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Contact Information

JON T FITZGERALD, DPM
543 3RD ST
STE C1
LAKE OSWEGO, OR97034-3067
 Phone: 503-636-9656
 Fax: 503-636-9657
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JON T FITZGERALD · (Male)

NPI # 1134111776
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/19/2005
Last updated 12/09/2009 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # DP00248
  • OR Medicaid 067533
  • OR Other 054399002 BLUE CROSS
  • OR Other F627 HEALTHNET
  • OR Other 3008597-02 HMOO
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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