Organization
RECONSTRUCTIVE FOOT & ANKLE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN V NORTON DPM (PRESIDENT)
(260) 969-1950
Entity
Organization
Contact information
Practice address
7910 W JEFFERSON BLVD, SUITE 300, FORT WAYNE, IN 46804-4159
(260) 969-1950
Mailing address
P.O. BOX 12754, FORT WAYNE, IN 46866-2754
(260) 969-1950
(260) 969-0988
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000881A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200847960
—
IN
05
—
200847960A
—
IN
Enumeration date
12/27/2006
Last updated
08/04/2008
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