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Organization

FORT WAYNE RETINA, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NEIL P FINNEN M.D. (PRESIDENT)
(260) 433-0164
Entity
Organization

Contact information

Practice address
11220 ILLINOIS ST STE 150, CARMEL, IN 46032-8887
(317) 817-1822
(317) 817-1898
Mailing address
11220 ILLINOIS ST STE 150, CARMEL, IN 46032-8887
(317) 817-1822
(317) 817-1898

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01050629A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1225014848
NPI
05
200218500
IN
05
200880960A
IN
01
DG0850
MEDICARE RAILROAD
IN
Enumeration date
06/01/2006
Last updated
05/07/2025
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