Organization
JOHN FORNAROTTO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M FORNAROTTO MD (OWNER)
(208) 234-4100
Entity
Organization
Contact information
Practice address
246 N 18TH AVE, POCATELLO, ID 83201-3356
(208) 234-4100
(208) 234-4192
Mailing address
246 N 18TH AVE, POCATELLO, ID 83201-3356
(208) 234-4100
(208) 234-4192
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
11/16/2017
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