Individual
WYATT JEFFRY GOTTSCHALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 248-7711
Mailing address
3304 SHOAFF PARK RIVER DR, FORT WAYNE, IN 46835-2035
(260) 804-4346
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004765A
IN
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
03/26/2026
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