Mark J Fitzmaurice, MD – Ophthalmology Physician

Key facts

NPI: 1992801047
Entity type: Individual (NPI type 1)
Primary specialty: Ophthalmology Physician 207W00000X
License: 27752 (KY)
Practice address: 800 Hospital Dr
Madisonville, KY 42431-1658
Phone: (270) 326-4800
Fax: (270) 326-4820
NPI assigned: Sep 16, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Ohio Valley Neurology LLC Neurology Physician · Madisonville, KY · NPI 1023005394

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Ohio Valley Neurology LLC		Current	Accepting new patients

Locations

200 Clinic Dr
Madisonville, KY 42431
Phone (270) 821-8874

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Ophthalmology Physician	207W00000X	27752	KY	Yes

Addresses

Primary practice location

800 Hospital Dr
Madisonville, KY 42431-1658

Mailing address

200 Clinic Dr
Madisonville, KY 42431-1661

Other identifiers

Identifier	Type	State	Issuer
64277528	Medicaid	KY
000000044250	Other		BCBS PIN
27752	Other	KY	LICENSE

Other providers in Madisonville, KY

All providers in Madisonville, KY · Ophthalmology Physician in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.