George S. Fortner
Vascular Surgeon
1615 Delaware St
Longview
, Washington 98632-2310
George S. Fortner
Vascular Surgeon
1615 Delaware St
Longview
, Washington 98632-2310
(360) 575-6749
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- George S. Fortner
- Po Box 3002
- Longview, WA
- Zip : 98632-0302
- Fax : (360) 575-6749
- Phone : (360) 414-2048
Second Address
- George S. Fortner
- 1615 Delaware St
- Longview, WA
- Zip : 98632-2310
- Fax : (360) 501-3555
- Phone : (360) 501-3500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | MD00016906 | WA |
National Provider Identifier
| NPI | 1154329324 |
|---|---|
| Provider Name | George S. Fortner |
| First Address | Longview, WA 98632-0302 |
| Second Address | Longview, WA 98632-2310 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/07/2005 |
| Last Update Date | 14/11/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0217049 | LABOR & IND. (01) | WA |
| 160747 | (05) | OR |
| 8395006 | (05) | WA |
| 8943476 | CRIME VICTIMS (01) | WA |
| A04489 | (02) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.