| NPI | 1497641153 |
|---|---|
| Former Legal Business Name | JAYNE S. FORTSON MD |
| Entity Type | Organization |
| Authorized Contact | JAYNE S FORTSON Owner 907-563-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |