Fortman, Karen T
Fortman, Karen T is an individual health care provider with primary practice located at 1086 Fairington Dr , Sidney OH 45365-8913. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Fortman, Karen T can be contacted via phone (937) 492-9197.Contact Information
Primary practice address
1086 Fairington Dr
Sidney OH 45365-8913
Phone: (937) 492-9197
Fax: (937) 492-1901
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4599 | Ohio |
Profile Details
| NPI number | 1205898145 |
|---|---|
| LBN Legal business name | Fortman, Karen T |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Nov 18th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205898145 | NPPES |
| Ohio | Other | 0176440002 | DMERC |
| Ohio | Other | 0176440001 | DMERC |
| Ohio | MEDICAID | 0991431 | DMERC |
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