Individual
DR. DOUGLAS S. FORNFEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
J6437
TX
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
J6437
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006918-01
CSHCN
TX
05
—
1006918-02
—
TX
01
—
200039622
RR/MEDICARE
TX
01
—
80313N
BLUE SHIELD
TX
Enumeration date
03/25/2006
Last updated
12/08/2021
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