Dewitt Charles Fortenberry in Texarkana - General Practice
Dewitt Charles Fortenberry - NPI 1114960473
Dewitt Charles Fortenberry is a General Practice in Texarkana, Texas. Dewitt Charles Fortenberry practices all healthcare services and medical treatments related to General Practice. The NPI Number for Dewitt Charles Fortenberry is 1114960473. The last update date is 2023-09-17.
Dewitt Charles Fortenberry's current location address is 2602 Saint Michael Dr, Texarkana, Texas. You can contact this provider via phone number 9033362391. The mailing address for Dewitt Charles Fortenberry is 2602 Saint Michael Dr, Texarkana, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dewitt Charles Fortenberry |
|---|---|
| Address | 2602 Saint Michael Dr, Texarkana, Texas |
| Phone Number | 9033362391 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1114960473 |
|---|---|
| Provider Enumeration Date | 2006-06-14 |
| Last Updated Date | 2023-09-17 |
Provider Mailing Address Detail
| Address | 2602 Saint Michael Dr |
|---|---|
| City | Texarkana |
| State | Texas (TX) |
| Post Code | 755032387 |
| Phone Number | 9033362391 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | L8691 |
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Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 167594401 | TX | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Dewitt Charles Fortenberry by the Centers for Medicare & Medicaid Services?
The Dewitt Charles Fortenberry has been assigned the NPI (National Provider Identifier) 1114960473 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Dewitt Charles Fortenberry's facilities are geographically located?
The facilities of Dewitt Charles Fortenberry are physically situated at the following location: 2602 Saint Michael Dr, Texarkana, TX, 755032387.
What is Dewitt Charles Fortenberry's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Dewitt Charles Fortenberry is General Practice, and the taxonomy classification code that categorizes this area of expertise is 208D00000X.
When was the Dewitt Charles Fortenberry's 1114960473 issued?
The Dewitt Charles Fortenberry's 1114960473 was issued on 2006-06-14.
As of what date were the details pertaining to Dewitt Charles Fortenberry last refreshed?
The information related to the Dewitt Charles Fortenberry, including its address, specialty, and other relevant details, was last updated on 2023-09-17.
NPI Number: 1932102142
Address: St. Jude Children's Research Hospital, Memphis, TN