Individual
GEORGE T KOLETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(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
207X00000X
Orthopaedic Surgery Physician
01071673A
IN
207X00000X
Orthopaedic Surgery Physician
4301062980
MI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
01071673A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000784327
ANTHEM
—
05
—
201117660
—
IN
01
—
P01128176
RAILROAD MEDICARE
—
Enumeration date
01/13/2006
Last updated
11/07/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us