Douglas S Fitzwater (NPI# 1619967106, PAC ID# 2365349768) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PEDIATRIC MEDICINE.
| Nation Provider ID (NPI) | 1619967106 |
| PAC ID by PECOS | 2365349768 |
| Professional Enrollment ID | I20040915000253 |
| Full Name | Douglas S Fitzwater |
| Organization Legal Name | DYERSBURG CLINIC CORP |
| Address |
108 W 15th St Caruthersville Clinic Caruthersville MO 63830-2202 |
| Phone Number | 5733330033 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | PEDIATRIC MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1658354238 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440072 | TENNOVA HEALTHCARE-DYERSBURG REGIONAL |
| 260070 | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| 260015 | TWIN RIVERS REGIONAL MEDICAL CENTER |
| 260183 | SAINT FRANCIS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 108 W 15th St, Caruthersville Clinic, Caruthersville, MO 63830-2202 | 5733330033 | DYERSBURG CLINIC CORP |
| 108 W 15th St, Caruthersville, MO 63830-2202 | 5733330033 | DYERSBURG CLINIC CORP |
| Organization Legal Name | DYERSBURG CLINIC CORP |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas Haynes Jr. | Internal Medicine | Dyersburg Clinic Corp | 305 E Tickle St, Dyersburg, TN 38024-3117 |
| Donna Bennett | Obstetrics/gynecology | Dyersburg Clinic Corp | 503 E Tickle St, Dyersburg, TN 38024-3165 |
| Craig Metcalf | Nurse Practitioner | Dyersburg Clinic Corp | 503 E Tickle St, Suite A, Dyersburg, TN 38024-3165 |
| Atta Ur Rehman Shahbaz | Cardiovascular Disease (cardiology) | Dyersburg Clinic Corp | 503 E Tickle St, Suite A, Dyersburg, TN 38024-3165 |
| Street Address |
108 W 15TH ST CARUTHERSVILLE CLINIC |
| City | CARUTHERSVILLE |
| State | MO |
| Zip | 63830-2202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angela Constant | Nurse Practitioner | Wt Regional Medical Associates | 108 W 15th St, West Tn Medical Group Primary Care Caruthersville, Caruthersville, MO 63830-2202 |
| April Nicole Walker | Nurse Practitioner | Wt Regional Medical Associates | 108 W 15th St, West Tn Medical Group Primary Care Caruthersville, Caruthersville, MO 63830-2202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin M Schroeder | Optometry | 400 Ward Ave, Caruthersville, MO 63830-1451 | |
| Allison L Whitener | Optometry | 400 Ward Ave, Caruthersville, MO 63830-1451 | |
| James W Bernard | Family Medicine | Pemiscot County Memorial Hospital | 106 W 12th St, Caruthersville, MO 63830-1890 |
| Lara Huffman | Psychiatry | Pemiscot County Memorial Hospital | 106 W 12th St, Caruthersville, MO 63830-1890 |
| Kristen S Culver | Optometry | T M Swinger and D V Mckillip, Ptr | 101 E 10th St A, Caruthersville, MO 63830-1919 |
| Douglas J Mckillip | Optometry | T M Swinger and D V Mckillip, Ptr | 101 E 10th St A, Caruthersville, MO 63830-1919 |
| Terrence M Swinger | Optometry | T M Swinger and D V Mckillip, Ptr | 101 E 10th St A, Caruthersville, MO 63830-1919 |
| John Okechukwu Nwora | Family Medicine | 1117 Ward Ave, 25 Dr Nworas Medical Clinic, Caruthersville, MO 63830-2622 |
| City | CARUTHERSVILLE |
| Zip Code | 63830 |
| Specialty | PEDIATRIC MEDICINE |
| City + Specialty | CARUTHERSVILLE + PEDIATRIC MEDICINE |
Please comment or provide details below to improve the information on Douglas S Fitzwater.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.