Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Grady Ausbur Fortner, MD

Individual provider Emergency Medicine Physician · NPI 1043636202

Dr. Grady Ausbur Fortner, MD is an Emergency Medicine Physician in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Guam and Virginia.

Licensed in
GU, VA
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

554 Keily St
Jacksonville, FL 32212
Phone: (757) 953-7550
Fax: (757) 953-7560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence M-2191 (GU)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 0116027243 (VA)

Record details

NPI number1043636202
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 12, 2014
Last updated in NPPESDecember 17, 2019
Certification dateDecember 17, 2019

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