Organization
PANCNER PSYCHIATRIC ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD J PANCNER M.D. (OWNER)
(260) 456-4880
Entity
Organization
Contact information
Practice address
2805 FAIRFIELD AVE, FORT WAYNE, IN 46807-1218
(260) 456-4880
(260) 456-3559
Mailing address
2805 FAIRFIELD AVE, FORT WAYNE, IN 46807-1218
(260) 456-4880
(260) 456-3559
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100049440
—
IN
Enumeration date
04/10/2007
Last updated
04/29/2008
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