Basic Information
Provider Information
NPI: 1316182744
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FITTON
FirstName: CONAR
MiddleName: PATRICK
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1514 JEFFERSON HWY
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701212429
CountryCode: US
TelephoneNumber: 5048424000
FaxNumber:  
Practice Location
Address1: 200 W ESPLANADE AVE
Address2: SUITE 401
City: KENNER
State: LA
PostalCode: 700652489
CountryCode: US
TelephoneNumber: 5044648588
FaxNumber: 5044648586
Other Information
ProviderEnumerationDate: 12/15/2008
LastUpdateDate: 11/14/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XAR3354292TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100XMD0000045443TNN Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RG0100X302217LAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
243050505LA MEDICAID
0755005805MS MEDICAID


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