NPI 1073688792
Eugene John Fortman
Practice location
- Address
- 1010 4th St SW STE 300, Mason City, IA 50401-2856
- Phone
- (641) 424-0301
- Fax
- (641) 424-0301
- Mailing address
- 2533 Hawk Hill Ln. SW, Rochester, MN 55902
Registered specialties
Periodontics
Primary
Registry record
- NPI
- 1073688792
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 21 Nov 2006
- Record last updated
- 17 Mar 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.