# THE EYE SURGICAL CENTER OF FORT WAYNE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588991228
- **Authorized official:** DR. JOHN REX PARENT M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (260) 422-5976

## Contact information

- **Practice address:** 321 E WAYNE ST, FORT WAYNE, IN 46802-2713
- **Practice address phone:** (260) 422-5976
- **Practice address fax:** (260) 424-4511
- **Mailing address:** 321 E WAYNE ST, FORT WAYNE, IN 46802-2713
- **Mailing address phone:** (260) 422-5976
- **Mailing address fax:** (260) 424-4511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/17/2009
- **Last updated:** 11/17/2009