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Organization
SLEEP CENTERS OF FORT WAYNE LLC
Active
Organization
SLEEP CENTERS OF FORT WAYNE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R. SMITH (PRESIDENT)
(260) 969-6450
Entity
Organization
Contact information
Practice address
7223 ENGLE RD STE 110, FORT WAYNE, IN 46804-2239
(260) 969-6450
(260) 969-6451
Mailing address
7223 ENGLE RD STE 110, FORT WAYNE, IN 46804-2239
(260) 969-6450
(260) 969-6451
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
—
—
2084N0400X
Neurology Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2007
Last updated
06/01/2012
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