DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DEWITT CHARLES FORTENBERRY, MD

Active Sole Proprietor

DEWITT CHARLES FORTENBERRY, MD is a General Practice healthcare provider located in TEXARKANA, Texas. NPI 1114960473 is currently active in the NPPES registry. Verify at CMS.

General Practice · TEXARKANA, TX

Registration Details

NPI Number
1114960473
Provider Type
Individual
Gender
Male
NPI Issued
Jun 14, 2006 (20.20161354359 yrs)
Last Updated
Sep 17, 2023
Licenses
L8691 (TX)
L8691 (TX)
Sole Proprietor
Yes

Practice Information

Address
2602 SAINT MICHAEL DR
SUITE 302
TEXARKANA, TX, 755032387
Browse TX providers · Browse ZIP 75503
Phone
9033362391
Primary Specialty
General Practice
208D00000X
Additional Specialty
General Practice

Other General Practice Providers in TEXARKANA, TX

Name Credential NPI
RONALD DAVID RUSH MD 1184802381
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.