Provider Demographics
NPI:1356302798
Name:FORTE, BILL JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:JEFFREY
Last Name:FORTE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7447 CENTRAL BUSINESS PARK DR
Mailing Address - Street 2:CITY OF NORFOLK COMMUNITY SERVICES BOARD
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-2831
Mailing Address - Country:US
Mailing Address - Phone:757-756-5600
Mailing Address - Fax:757-937-0542
Practice Address - Street 1:7447 CENTRAL BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-2831
Practice Address - Country:US
Practice Address - Phone:757-756-5600
Practice Address - Fax:757-937-0542
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010525762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945565Medicaid
VA4945565Medicaid
VAH49721Medicare UPIN