Organization
NORTHEAST INDIANA UROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B BRINKMAN MD (PRESIDENT)
(260) 436-6667
Entity
Organization
Contact information
Practice address
2512 E DUPONT RD, SUITE 100, FORT WAYNE, IN 46825-1609
(260) 436-6667
(260) 469-7437
Mailing address
2512 E DUPONT RD, SUITE 100, FORT WAYNE, IN 46825-1609
(260) 436-6667
(260) 469-7437
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0748972
—
OH
05
—
100081380
—
IN
Enumeration date
05/18/2006
Last updated
04/09/2013
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