Provider Demographics
NPI:1033484282
Name:OCCUPATIONAL HEALTH PROFESSIONALS, INC
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH PROFESSIONALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-781-6477
Mailing Address - Street 1:PO BOX 51328
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-5628
Mailing Address - Country:US
Mailing Address - Phone:270-781-6477
Mailing Address - Fax:270-781-6479
Practice Address - Street 1:5796 NASHVILLE TD, STE A
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101
Practice Address - Country:US
Practice Address - Phone:270-781-6477
Practice Address - Fax:270-781-6479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine