Provider Demographics
NPI:1437640877
Name:FITZ, JOSEPH T (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:FITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 S INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-2846
Mailing Address - Country:US
Mailing Address - Phone:414-520-0433
Mailing Address - Fax:
Practice Address - Street 1:ASPIRUS WAUSAU FAMILY MEDICINE
Practice Address - Street 2:425 WIND RIDGE DRIVE
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401
Practice Address - Country:US
Practice Address - Phone:715-675-3391
Practice Address - Fax:715-675-5262
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI74703-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program