Individual
DR. GREGORY LAMAR FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222S MAIN ST, REIDSVILLE, GA 30453-4602
(912) 394-1002
Mailing address
222S MAIN ST, REIDSVILLE, GA 30453-4602
(912) 394-1002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032733
GA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
032733
GA
Other
Enumeration date
06/05/2007
Last updated
12/16/2015
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