Individual
DANIEL B FORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 SOUTHCREST CIR, SUITE 210, SOUTHAVEN, MS 38671-6726
(662) 536-1944
(662) 536-1947
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19431
MS
208600000X
Surgery Physician
44480
TN
Other
Enumeration date
08/17/2006
Last updated
06/15/2020
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