MR. Jerry Matthew Fortenberry
NPI #1952691487 in Columbus, Mississippi
Provider Information
- NPI Number
- 1952691487
- Entity Type
- Individual
- Name
- MR. Jerry Matthew Fortenberry
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Pharmacist
- Enumeration Date
- Apr 18, 2011
- Last Updated
- Apr 18, 2011
Practice Location
- Address
- 1800 HIGHWAY 45 N
- City
- Columbus
- State
- Mississippi
- ZIP Code
- 39705-2110
- Phone
- (662) 327-6138
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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