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Mr. Keith Wesley Fort, PA-C
Physician Assistant in Jonesboro, Georgia
NPI 1487888061

Keith Wesley Fort is a Physician Assistant based in Atlanta, GA. Keith Wesley Fort practices in Jonesboro, GA and has the professional credentials of PA-C. The NPI Number for Keith Wesley Fort is 1487888061 and holds a License No. 6400 (Georgia).

The current practice location address for Keith Wesley Fort is 2400 Mount Zion Pkwy, Jonesboro, GA and can be reached out via phone at 201-943-9100 and via fax at 201-943-7308. You can also correspond with Keith Wesley Fort through the mailing address at 3495 PIEDMONT RD NE, ATLANTA, GA - 30305-1717 (mailing address contact number: 404-504-5678).

Location: 2400 Mount Zion Pkwy, Jonesboro, GA, 30305-1717
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487888061
Provider Name
Keith Wesley Fort
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
2400 Mount Zion Pkwy, Jonesboro, GA, 30305-1717
Phone Number
201-943-9100
Fax Number
201-943-7308
Provider Enumeration Date
05/11/2009
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
162546NMS 01 NJ MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
2400 Mount Zion Pkwy
City
Jonesboro
State
Georgia
Zip
30236-2500
Phone Number
201-943-9100
Fax Number
201-943-7308
person
Provider Business Mailing Address Details
Address
2400 Mount Zion Pkwy
City
Jonesboro
State
Georgia
Zip
30236-2500
Phone Number
201-943-9100
Fax Number
201-943-7308
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
25MP00214500 (New Jersey)
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
6400 (Georgia)
Definition
Definition to come...
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