Organization
COLON-RECTAL SURGEONS OF FORT WAYNE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HAUSCHILD (BUSINESS MANAGER)
(260) 609-3734
Entity
Organization
Contact information
Practice address
7900 W JEFFERSON BLVD, SUITE 302, FORT WAYNE, IN 46804-4128
(260) 435-1900
(260) 435-1800
Mailing address
7900 W JEFFERSON BLVD, SUITE 302, FORT WAYNE, IN 46804-4128
(260) 435-1900
(260) 435-1800
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
IN
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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