Individual
BARRY V FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
100 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2146
(901) 322-9080
(901) 322-9097
Mailing address
100 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2146
(901) 322-9080
(901) 322-9097
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2365
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124541
—
MS
05
—
3981982
—
TN
01
—
4041246
BCBS TN
TN
Enumeration date
06/26/2006
Last updated
10/31/2007
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