Individual
DR. JESSICA L FORTWENGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 EASTPOINT PKWY STE 305, LOUISVILLE, KY 40223-5106
(502) 389-5823
Mailing address
2600 EASTPOINT PKWY STE 305, LOUISVILLE, KY 40223-5106
(502) 389-5823
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42398
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000650401
ANTHEM
KY
01
—
50027705
PASSPORT
KY
05
—
7100104670
—
KY
01
—
P00854282
RAILROAD MEDICARE
KY
Enumeration date
02/12/2009
Last updated
12/22/2025
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