Organization
INDIANA ADVANCED PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNELLE BACON (RCM DIRECTOR)
(810) 357-6984
Entity
Organization
Contact information
Practice address
7230 ENGLE RD STE 102, FORT WAYNE, IN 46804-2234
(260) 888-1378
(260) 387-6763
Mailing address
1700 W BIG BEAVER RD STE 300, TROY, MI 48084-3514
(260) 888-1378
(260) 387-6763
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
02/09/2026
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