Fortress, Kenneth Gerald

Fortress, Kenneth Gerald is an individual health care provider with primary practice located at 520 S 7Th St , Vincennes IN 47591-1038. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Fortress, Kenneth Gerald can be contacted via phone (812) 882-5220.

Contact Information

Primary practice address
520 S 7Th St Vincennes IN 47591-1038
Phone: (812) 882-5220
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 01032775A Indiana

Profile Details

NPI number 1487650180
LBN Legal business name Fortress, Kenneth Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Apr 26th, 2022 - about 4 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 1487650180 NPPES
Indiana Other 176600A MEDICARE
Indiana Other CB5232 MEDICARE
Indiana Other 111890C MEDICARE
Indiana MEDICAID 100259680A MEDICARE
Indiana Other 000000082508 MEDICARE
Indiana Other CA8380 MEDICARE

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