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Individual

MR. JAMES MITCHELL FORTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MHPP

Contact information

Practice address
525 WISTERIA DR, NORTH LITTLE ROCK, AR 72118-3567
(501) 594-5200
(501) 594-5244
Mailing address
PO BOX 180, PARON, AR 72122-0180
(501) 594-5200
(501) 594-5244

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
AR

Other

Enumeration date
07/29/2008
Last updated
07/29/2008
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