Individual
LAURENCE J FUORTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 335-9819
(319) 353-5649
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 335-9819
(319) 353-5649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25114
IA
207RP1001X
Pulmonary Disease Physician
25114
IA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
25114
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251959
—
IA
01
—
25195
WELLMARK BCBS
IA
Enumeration date
11/09/2005
Last updated
11/30/2007
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