Organization
INDIANA UNIVERSITY HEALTH FORT WAYNE PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN W. VANATOR (CFO)
(317) 963-3395
Entity
Organization
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3111
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(888) 484-3258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/28/2020
Last updated
11/13/2023
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