Individual
DR. JEFFREY L HARTZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 482-5060
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01061830A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058940020
MEDICARE PTAN
IN
05
—
200949720
—
IN
01
—
P01401382
RAILROAD MEDICARE
IN
Enumeration date
10/26/2006
Last updated
09/02/2025
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