Individual
MARK ROUTON FORTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 HAMILTON RD STE B, COLUMBUS, GA 31904-8856
(706) 655-8800
(706) 940-9767
Mailing address
2200 HAMILTON RD STE B, COLUMBUS, GA 31904-8856
(706) 655-8800
(706) 940-9767
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
024937
GA
207RG0100X
Gastroenterology Physician
24937
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000274612
—
GA
01
—
10BDHLT
MEDICARE PTAN
GA
Enumeration date
09/25/2006
Last updated
08/22/2022
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