Individual
JOHN PAUL FORTNEY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6000
Mailing address
215 ROSEMONT AVE, SAINT LOUIS, MO 63119-2412
(314) 968-7370
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36601
MO
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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