Individual
LEANNE M FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6925 E 96TH ST, #150, INDIANAPOLIS, IN 46250-3648
(317) 842-2909
(317) 576-5313
Mailing address
6925 E 96TH ST, #150, INDIANAPOLIS, IN 46250-3648
(317) 842-2909
(317) 576-5313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01055016
IN
207Q00000X
Family Medicine Physician
01055016A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000313038
ANTHEM
IN
Enumeration date
07/25/2006
Last updated
07/28/2008
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