Individual
JOE BRENT FORTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1911 E JACKSON ST, HUGO, OK 74743-4249
(580) 326-7541
Mailing address
PO BOX 781, HUGO, OK 74743-0781
(580) 579-8497
(580) 326-3910
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11961
OK
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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