Organization
OPHTHALMOLOGY CONSULTANTS OF FORT WAYNE PC
Active
Other names
Surgery Center of Ophthalmology Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA PIEPER (PRACTICE MANAGER)
(260) 436-7205
Entity
Organization
Contact information
Practice address
7232 ENGLE RD, FORT WAYNE, IN 46804-2222
(260) 436-7205
(260) 432-1339
Mailing address
7232 ENGLE RD, FORT WAYNE, IN 46804-2222
(260) 436-7205
(260) 432-1339
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
05-009567-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200177420A
—
IN
01
—
490003832
RR MEDICARE
IN
Enumeration date
11/29/2005
Last updated
08/05/2020
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