Individual
JOHN B FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-1800
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
139794
NY
2086S0102X
Surgical Critical Care Physician
Primary
139794
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00849683
—
NY
Enumeration date
05/15/2006
Last updated
01/23/2009
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