Individual
DR. DAVID K WYSONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3012 E STATE BLVD, FORT WAYNE, IN 46805-4737
(260) 471-6830
(260) 471-6704
Mailing address
3012 E STATE BLVD, FORT WAYNE, IN 46805-4737
(260) 471-6830
(260) 471-6704
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000579
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100081210
—
IN
Enumeration date
07/03/2006
Last updated
06/13/2008
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