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Individual

DR. KENNETH R AUSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11104 PARKVIEW CIRCLE DR STE 20, FORT WAYNE, IN 46845-1733
(270) 266-5370
(260) 266-5379
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01061694A
IN
207L00000X
Anesthesiology Physician
15466R
LA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01061694A
IN

Other

Enumeration date
01/21/2006
Last updated
06/25/2025
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