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Individual

BARRY THOMAS WERTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001953A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102422373
ANTHEM PTAN
IN
05
300003649
IN
Enumeration date
05/04/2015
Last updated
11/05/2024
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