Most Relevant Information
Provider Data
| NPI Number: | 1003072158 |
| Provider Name: | JAMES MITCHELL FORTNER MHPP |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/29/2008 |
| Last Updated: | 07/29/2008 |
Provider Practice Location
525 WISTERIA DR
NORTH LITTLE ROCK
AR
721183567
Practice Location Phone/Fax
| Phone: | 5015945200 |
| Fax: | 5015945244 |
Provider Mailing Location
PO BOX 180
PARON
AR
721220180
Provider Mailing Phone/Fax
| Phone: | 5015945200 |
| Fax: | 5015945244 |