Fortner, George S.

Fortner, George S. is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2310. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Fortner, George S. can be contacted via phone (360) 501-3500.

Contact Information

Primary practice address
1615 Delaware St Longview WA 98632-2310
Phone: (360) 501-3500
Fax: (360) 501-3555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD00016906 Washington

Profile Details

NPI number 1154329324
LBN Legal business name Fortner, George S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Nov 14th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154329324 NPPES
Washington MEDICAID 8395006
Washington Other 8943476
Washington MEDICAID 160747
Washington Other 0217049

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