Individual
LARRY MAX FORT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4323 CAROTHERS PKWY STE 208, FRANKLIN, TN 37067-5916
(615) 778-0010
Mailing address
2534 SAINT JAMES DR, FRANKLIN, TN 37064-6753
(615) 585-6218
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
10015
TN
367500000X
Certified Registered Nurse Anesthetist
15554
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
APN0000010015
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3626436
—
TN
01
—
4067168
BLUE SHIELD
TN
01
—
7235513
AETNA PPO
TN
Enumeration date
07/03/2006
Last updated
05/08/2026
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