Provider Demographics
NPI:1033319132
Name:RICHARD H FITTON JR MD INC
Entity Type:Organization
Organization Name:RICHARD H FITTON JR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HOWORTH
Authorized Official - Last Name:FITTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:508-676-3411
Mailing Address - Street 1:1030 PRESIDENT AVE RM 124
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-676-3411
Mailing Address - Fax:508-235-6665
Practice Address - Street 1:1030 PRESIDENT AVE RM 124
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-676-3411
Practice Address - Fax:508-235-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24500207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
739115OtherTUFTS
MAM11520OtherBCBS MA
MA23591OtherBOSTON MEDICAL CENTER
MAMB6198OtherHEALTHNET
RIRF00406OtherEDS MEDICAID
B20429401OtherCIGNA
MA0007923OtherNEIGHBORHOOD HEALTHPLAN
1001000OtherUNITED HEALTH
MA19282OtherHARVARD PILGRIM HEALTHCAR
RI4189OtherBCBS RHODE ISLAND
84875OtherAETNA
889509OtherFIRST HEALTH
MA9736743Medicaid
S006975OtherTRICARE
MAMB6198OtherHEALTHNET
B75234Medicare UPIN