William Jay Fortner, MD
Individual provider Active NPI Family Medicine Physician · Kaufman, TX
NPI 1477510899 · NPPES record last updated Jun 3, 2014
Key facts
- NPI
- 1477510899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- D4999 (TX)
- Practice address
- 4 Climbing Tree
Kaufman, TX 75142-3012 - Phone
- (972) 962-2551
- Fax
- (972) 962-2551
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D4999 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primamed Physicians PLLC | Past | Accepting new patients | |
| Primamed Physicians PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D4999 | TX | Yes |
Addresses
Primary practice location
4 Climbing Tree
Kaufman, TX 75142-3012
Mailing address
PO Box 356
Kaufman, TX 75142-0356
Phone (972) 962-2551
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127118101 | Medicaid | TX |
Other providers in Kaufman, TX
- Tina Enderle
- Exceldent PLLC
- Avery Nicolette Fain
- Family and Child Guidance Center
- Marisa Fleck
- Darla R Fountain
- Ashlyn Mari Fouret
- Crystal Kattie Fox
- Darren Heath Garner
- Genesis Anesthesia, PLLC
All providers in Kaufman, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.