Individual
MR. JEAN GUY FORTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 ROSS CLARK CIRCLE, DOTHAN, AL 36301
(334) 793-2211
(334) 793-7161
Mailing address
2800 ROSS CLARK CIRCLE, DOTHAN, AL 36301
(334) 793-2211
(334) 793-7161
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00009017
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000046580
—
AL
Enumeration date
08/30/2006
Last updated
02/26/2010
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