Provider Demographics
NPI:1932145919
Name:FRITINGER, THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:FRITINGER
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 1:2108 YORK CIR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-4129
Mailing Address - Country:US
Mailing Address - Phone:801-451-8918
Mailing Address - Fax:801-584-2590
Practice Address - Street 1:982 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4571
Practice Address - Country:US
Practice Address - Phone:801-479-4105
Practice Address - Fax:801-584-2590
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070989207Q00000X
CAA86934207Q00000X
UT5903993-1205207Q00000X
PAMD069573L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine