Organization
ORTHOPAEDICS NORTHEAST PC
Active
Parent organization
ORTHOPAEDICS NORTHEAST PC
Other names
Surgery ONE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOPAEDICS NORTHEAST PC
Authorized official
MS. BARBARA HATHAWAY (CREDENTIALING OFFICER)
(260) 490-6970
Entity
Organization
Contact information
Practice address
11420 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1729
(260) 484-8551
(260) 490-6996
Mailing address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 490-6996
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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