Individual
DR. JOHN REX PARENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
321 E WAYNE ST, FORT WAYNE, IN 46802-2713
(260) 424-5656
(260) 424-4511
Mailing address
4625 N WASHINGTON RD, FORT WAYNE, IN 46804-1831
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01023963
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083765
ANTHEM
IN
05
—
0420226
—
OH
01
—
1669
PHYSICIAN'S HEALTH PLAN
IN
05
—
200014170
—
IN
Enumeration date
08/12/2006
Last updated
01/06/2011
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