Organization
FORT WAYNE ORTHOPAEDICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERALD L COOPER MD (PRESIDENT)
(260) 436-8686
Entity
Organization
Contact information
Practice address
217 W WAYNE ST, FORT WAYNE, IN 46802-3605
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
50002482A
IN
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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