Organization
EAR, NOSE & THROAT ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN D. HERR MD (PARTNER/PRESIDENT)
(260) 426-8117
Entity
Organization
Contact information
Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
50000001A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0751833
—
OH
05
—
100050300
—
IN
Enumeration date
12/22/2005
Last updated
01/08/2013
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