Fortunato, Joseph Domenic

Fortunato, Joseph Domenic is an individual health care provider with primary practice located at 6321 N Keystone Ave Ste A , Indianapolis IN 46220-2156. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Fortunato, Joseph Domenic can be contacted via phone (317) 257-2225.

Contact Information

Primary practice address
6321 N Keystone Ave Ste A Indianapolis IN 46220-2156
Phone: (317) 257-2225
Fax: (317) 257-0646
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 08001070A Indiana

Profile Details

NPI number 1639157407
LBN Legal business name Fortunato, Joseph Domenic
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Nov 12th, 2024 - about 2 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 1639157407 NPPES
Indiana Other 000000091939 ANTHEM BC/BS
Indiana Other 4355508 ANTHEM BC/BS
Indiana MEDICAID 100120180A ANTHEM BC/BS

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