Individual
RICHARD N FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
412 SW LANDMARK CIRCLE, GERONIMO, OK 73543
(580) 357-8198
Mailing address
412 SW LANDMARK CIRCLE, GERONIMO, OK 73543
(580) 357-8198
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0048255
OK
Other
Enumeration date
08/29/2005
Last updated
07/08/2007
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