Individual
DR. KAREN T FORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1086 FAIRINGTON DR, SIDNEY, OH 45365-8913
(937) 492-9197
(937) 492-1901
Mailing address
1086 FAIRINGTON DR, SIDNEY, OH 45365-8913
(937) 492-9197
(937) 492-1901
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4599
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176440001
DMERC
OH
01
—
0176440002
DMERC
OH
05
—
0991431
—
OH
Enumeration date
04/05/2006
Last updated
11/18/2022
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