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Organization

SLEEP CENTERS OF FORT WAYNE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN R. SMITH (PRESIDENT)
(260) 969-6450
Entity
Organization

Contact information

Practice address
7223 ENGLE RD STE 110, FORT WAYNE, IN 46804-2239
(260) 969-6450
(260) 969-6451
Mailing address
7223 ENGLE RD STE 110, FORT WAYNE, IN 46804-2239
(260) 969-6450
(260) 969-6451

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
2084N0400X
Neurology Physician
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary

Other

Enumeration date
06/29/2007
Last updated
06/01/2012
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