Individual
WILLIAM B LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 484-9603
Mailing address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 484-9603
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
01021529A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0229327
—
OH
Enumeration date
07/18/2005
Last updated
10/20/2010
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