Fortson, Mark Wilbur

Fortson, Mark Wilbur is an sole proprietor health care provider with primary practice located at 2255 Jfk Rd , Dubuque IA 52002-2846. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Fortson, Mark Wilbur can be contacted via phone (563) 582-4357.

Contact Information

Primary practice address
2255 Jfk Rd Dubuque IA 52002-2846
Phone: (563) 582-4357
Fax: (563) 582-5718
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 27778 Iowa

Profile Details

NPI number 1467413914
LBN Legal business name Fortson, Mark Wilbur
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2006
Last updated May 8th, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1467413914 NPPES
Iowa Other 35557 BLUE CROSS WELLMARK BLUE
Iowa MEDICAID 1065847 BLUE CROSS WELLMARK BLUE

Popular Providers