Organization
INDIANA SURGICAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD HIVELY (BUSINESS MANAGER)
(260) 484-9612
Entity
Organization
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 305, FORT WAYNE, IN 46845-1715
(260) 484-9611
(260) 484-1004
Mailing address
11141 PARKVIEW PLAZA DR STE 305, FORT WAYNE, IN 46845-1715
(260) 484-9611
(260) 484-1004
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270371
—
OH
05
—
100055660A
—
IN
01
—
CA7015
MEDICARE RAILROAD
IN
Enumeration date
12/20/2005
Last updated
07/29/2008
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