Individual
DR. WILLIAM P FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
107 E 1ST ST, TRENTON, TN 38382-1841
(731) 855-0811
(731) 855-4725
Mailing address
PO BOX 88, TRENTON, TN 38382-0088
(731) 855-0811
(731) 855-4725
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD435
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9200
TLC PIN
TN
Enumeration date
10/04/2006
Last updated
01/16/2008
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