DR. MARK WILBUR FORTSON (NPI# 1467413914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467413914 |
| Entity Type | Individual |
| Full Name | DR. MARK WILBUR FORTSON |
| Credential | M.D. |
| Practice Address |
2255 Jfk Rd Dubuque IA 52002-2846 |
| Mailing Address |
2933 Wilderness Dr Dubuque IA 52001-1535 |
| Practice Telephone | 5635824357 |
| Practice Fax Number | 5635825718 |
| Mailing Telephone | 5635571414 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2013-05-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
27778 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1065847 | 05 | |
| IA | BLUE CROSS WELLMARK BLUE | 35557 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457452591 | Mark Routon Fortson | Internal Medicine | 2300 Machester Expy, Ste A 201, Columbus, GA 31904-6856 | 2006-09-25 |
| Street Address |
2255 JFK RD |
| City | DUBUQUE |
| State | IA |
| Zip Code | 52002-2846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447874011 | Carissa Aileen Gilligan | Pharmacist | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2020-05-30 |
| 1770107328 | Pamela Stierman | Pharmacist | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2020-05-29 |
| 1972017937 | Daniel Mark Finn | Social Worker | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2017-11-28 |
| 1104342823 | Beverly Kueter | Social Worker | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2017-08-15 |
| 1336508787 | Amanda Cook | Social Worker | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2016-02-13 |
| 1124400510 | Benjamin Allen Shaw | Social Worker | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2015-06-23 |
| 1700225232 | Amanda Reynolds | Counselor | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2013-06-18 |
| 1881032829 | James Guentherman | Counselor | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2013-06-12 |
| 1871830018 | Tina Lee Shade | Specialist | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2013-01-08 |
| 1952673089 | Julie C Homb | Counselor | 2255 Jfk Rd, Dubuque, IA 52002-2846 | 2012-02-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144725193 | Rebecca Marie Fitzpatrick | Pharmacist | 7425 Chavenelle Rd Ste 300, Dubuque, IA 52002 | 2018-03-29 |
| 1598020943 | Steven Matthew Leifker | Dentist | 1645 John F. Kennedy Rd, Dubuque, IA 52002 | 2012-07-11 |
| 1922364280 | Susan A Neuser | Pharmacist | 74 25 Chavenelle Rd, Dubuque, IA 52002 | 2012-04-11 |
| 1720308240 | Yakov S Zagalskiy | Family Medicine | 1500 Associates Drive, Dubuque, IA 52002 | 2010-06-07 |
| 1689904690 | Meryl Rae Welsh | Counselor | 2255 Jkf Road, Dubuque, IA 52002 | 2010-01-14 |
| 1982864047 | Joel Gregory Thielen | Acupuncturist | 1880 Radford Road, Dubuque, IA 52002 | 2008-06-12 |
| 1609052323 | Jason E Meyer Physical Therapy PC | Clinic/Center | 2300 John F Kennedy Rd, Dubuque, IA 52002 | 2008-01-11 |
| 1508053828 | Assisted Living Concepts Inc | Assisted Living Facility | 2700 Matthew John Drive, Dubuque, IA 52002 | 2007-10-01 |
| 1588863252 | Miracle Ear | Audiologist-Hearing Aid Fitter | 555 Jf Kennedy Road, Dubuque, IA 52002 | 2007-07-13 |
| 1639383599 | Michelle Ann Gardner | Optometrist | 808 Wacker Dr, Dubuque, IA 52002 | 2007-05-10 |
| Find all providers in zip 52002 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922078500 | Patrick Ray Sterrett | Psychiatry & Neurology | 3405 Lake Ridge Dr, Dubuque, IA 52003-7800 | 2006-01-25 |
| 1659414936 | Dubuque Neurology & Neurodiagnostic Center, P.C. | Psychiatry & Neurology | 3405 Lake Ridge Dr, Dubuque, IA 52003-7800 | 2007-02-15 |
| 1730229121 | Preeti Mary Joseph | Psychiatry & Neurology | 1000 Langworthy St, Dubuque, IA 52001-7313 | 2007-02-07 |
| 1134176308 | The Finley Hospital | Psychiatry & Neurology | 350 N Grandview Ave, Dubuque, IA 52001-6388 | 2006-05-31 |
| 1992757553 | Marsha Horwitz | Psychiatry & Neurology | 1000 Langworthy St, Dubuque, IA 52001-7313 | 2006-05-16 |
| 1659321339 | Laurie Anne Garms | Psychiatry & Neurology | 1000 Langworthy St, Dubuque, IA 52001-7313 | 2006-05-11 |
| 1639138837 | Ronald Scott Sims | Psychiatry & Neurology | 2140 John F Kennedy Rd, Suite C, Dubuque, IA 52002-3883 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073179784 | Brooke Kubat | Psychiatry & Neurology | 200 Hawkins Dr Dept of Neurology, Iowa City, IA 52242-1009 | 2019-05-17 |
| 1275069627 | Betsy Love | Psychiatry & Neurology | 1200 Sw State St, Suite 1d, Ankeny, IA 50023-2547 | 2017-05-04 |
| 1255712618 | Marie Chase | Psychiatry & Neurology | 2710 Saint Francis Dr Ste 201, Waterloo, IA 50702-5664 | 2015-06-11 |
| 1629463062 | Collin Kreple | Psychiatry & Neurology | 2631 Irving Ave, Iowa City, IA 52246-4127 | 2015-04-02 |
| 1497079545 | Michael J Stein | Psychiatry & Neurology | 611 S 28th St, West Des Moines, IA 50265-5559 | 2010-03-18 |
| 1245364728 | Teresa B Rosales | Psychiatry & Neurology | 1800 North 16th St., Clarinda, IA 51632 | 2007-03-15 |
| 1801922018 | Burlington Neurology and Sleep Clinic, Plc | Psychiatry & Neurology | 1225 S Gear Ave Ste 153, Mercy Plaza, West Burlington, IA 52655-1686 | 2007-02-24 |
| 1972646917 | Heike Schmolck | Psychiatry & Neurology | Mercy Ruan Neurology Clinic Central, 1111 6th Ave East Tower Suite A100, Des Moines, IA 50314 | 2007-02-15 |
| 1144329996 | Juan A Acosta | Psychiatry & Neurology | 1015 Duff Avenue, Mcfarland Clinic PC, Ames, IA 50010-3014 | 2006-09-21 |
| 1205945094 | Michael Leon Pogel | Psychiatry & Neurology | 2000 S Main St, Fairfield, IA 52556-9572 | 2006-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.