Provider Demographics
NPI:1063544807
Name:FITZPATRICK, THOMAS SEAN (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:SEAN
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 FRANK THOMAS ROAD
Mailing Address - Street 2:
Mailing Address - City:DEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71328
Mailing Address - Country:US
Mailing Address - Phone:318-466-9322
Mailing Address - Fax:
Practice Address - Street 1:211 FOURTH ST.
Practice Address - Street 2:5TH FLOOR
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-767-2892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist