Organization
QHG OF FORT WAYNE COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MUSIC (DIRECTOR, PROVIDER ENROLLMENT)
(615) 465-7377
Entity
Organization
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3843
(260) 637-1601
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/08/2006
Last updated
10/01/2024
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