Provider Demographics
NPI:1912038449
Name:FORNO, PHILIP CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:CHRISTOPHER
Last Name:FORNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 CALLE DE LA VUELTA
Mailing Address - Street 2:SUTIE C103
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4742
Mailing Address - Country:US
Mailing Address - Phone:505-982-5014
Mailing Address - Fax:505-982-2687
Practice Address - Street 1:2100 CALLE DE LA VUELTA
Practice Address - Street 2:SUTIE C103
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4742
Practice Address - Country:US
Practice Address - Phone:505-982-5014
Practice Address - Fax:505-982-2687
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2009-01502086S0105X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery