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Organization

SUMMIT PLASTIC SURGERY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY FIECHTER (PRACTICE ADMINISTRATOR)
(260) 490-7111
Entity
Organization

Contact information

Practice address
7920 W JEFFERSON BLVD STE 200, FORT WAYNE, IN 46804-4166
(260) 490-7111
(260) 490-2286
Mailing address
7920 W JEFFERSON BLVD STE 200, FORT WAYNE, IN 46804-4166
(260) 490-7111
(260) 490-2286

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200375290A
IN
05
2289394
OH
Enumeration date
12/16/2005
Last updated
04/18/2017
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