Organization
ORTHOPAEDICS NORTHEAST PC
Active
Other names
Surgery One
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C PRITCHARD MD (PRESIDENT)
(260) 484-8551
Entity
Organization
Contact information
Practice address
11420 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1729
(260) 484-8551
(260) 490-6996
Mailing address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 490-6996
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100274410
—
IN
01
—
490001781
RAIL ROAD MEDICARE
IN
Enumeration date
01/10/2006
Last updated
10/28/2010
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