Organization
ORTHOPAEDICS NORTHEAST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA J HATHAWAY (CREDENTIALING OFFICER)
(260) 408-2203
Entity
Organization
Contact information
Practice address
11136 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 484-8550
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 408-2203
(260) 408-8014
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
50001907A
IN
Other
Enumeration date
01/11/2006
Last updated
06/01/2015
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