Organization
ASSOCIATED SURGEONS AND PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILA BRAGER (CREDENTIALING COORDINATOR)
(260) 432-4400
Entity
Organization
Contact information
Practice address
7920 W. JEFFERSON BLVD., STE. 230, FORT WAYNE, IN 46804-4166
(260) 432-7600
(260) 436-8498
Mailing address
2518 E DUPONT RD, FORT WAYNE, IN 46825-1675
(260) 432-4400
(260) 969-6833
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201338430
—
IN
Enumeration date
10/20/2016
Last updated
10/20/2016
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