Individual
JAMES D FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6940 MICHIGAN RD, INDIANAPOLIS, IN 46268-2800
(317) 266-2901
(317) 266-2916
Mailing address
8910 PURDUE RD, STE.500, INDIANAPOLIS, IN 46268-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01041534A
IN
208000000X
Pediatrics Physician
01057726
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100217980
—
IN
Enumeration date
04/28/2006
Last updated
04/01/2011
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