Provider Demographics
NPI:1821011750
Name:FITCH, DONALD LAWRENCE (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LAWRENCE
Last Name:FITCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-968-2330
Mailing Address - Fax:
Practice Address - Street 1:119 N STATE ST
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-0315
Practice Address - Country:US
Practice Address - Phone:215-968-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001428152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
062592001OtherDMERC
PA001705153Medicaid
U07828Medicare UPIN
PA0625920001Medicare NSC