Individual
DR. JAMES EVERETT FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7580 CLARINGTON CV, SOUTHAVEN, MS 38671-5657
(662) 349-1940
(662) 349-3212
Mailing address
PO BOX 847, CORDOVA, TN 38088-0847
(901) 821-0338
(901) 507-8292
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
06635
MS
208600000X
Surgery Physician
MD0000007792
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017199
—
MS
Enumeration date
01/29/2007
Last updated
01/28/2021
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