Organization
FORT WAYNE ORTHOPAEDICS, LLC
Active
Other names
Fort Wayne Orthopedics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JERALD L. COOPER M.D. (PRESIDENT)
(260) 436-8686
Entity
Organization
Contact information
Practice address
800 BROADWAY, STE 215, FORT WAYNE, IN 46802-2149
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 432-5075
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
50002482
IN
207XS0106X
Orthopaedic Hand Surgery Physician
50002482
IN
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
50002482
IN
207XS0117X
Orthopaedic Surgery of the Spine Physician
50002482
IN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
50002482
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
50002482
IN
207XX0801X
Orthopaedic Trauma Physician
50002482
IN
213E00000X
Podiatrist
50002482
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
50002482
IN
213ES0131X
Foot Surgery Podiatrist
50002482
IN
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
50002482
IN
363A00000X
Physician Assistant
50002482
IN
363LA2200X
Adult Health Nurse Practitioner
50002482
IN
363LF0000X
Family Nurse Practitioner
50002482
IN
Other
Enumeration date
04/16/2014
Last updated
01/27/2015
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