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General NPI Number Information
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NPI Number | 1487703104
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Entity Type | Organization
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Legal Business Name | DR JOHN J. FORNEY M.D., L.L.C.
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 03/26/2008
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Provider Practice Location Address
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Address Line | 181 SAINT PHILIP ST
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City | CHARLESTON
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State | SC
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Zip | 29403-6841
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Country | US
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Telephone | 843-693-4546
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Fax | 843-724-8393
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Provider Business Mailing Address
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Address Line | 181 SAINT PHILIP ST
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City | CHARLESTON
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State | SC
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Zip | 29403-6841
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Country | US
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Telephone | 843-693-4546
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Fax | 843-724-8393
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN JOSEPH FORNEY
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Credential | M.D.
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Telephone | 843-693-4546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23885
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License Number State | SC
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