Organization
RICHARD NEIL FORTUNE CRNA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD NEIL FORTUNE CRNA (PRESIDENT)
(580) 357-8198
Entity
Organization
Contact information
Practice address
412 SW LANDMARK CIR, GERONIMO, OK 73543-5144
(580) 357-8198
Mailing address
412 SW LANDMARK CIR, GERONIMO, OK 73543-5144
(580) 357-8198
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0048255
OK
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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