Individual
JOSEPH W EGBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10315 DAWSONS CREEK BLVD STE AB, FORT WAYNE, IN 46825-1912
(260) 436-7875
(260) 432-9812
Mailing address
PO BOX 843603, DALLAS, TX 75284-3603
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
133787
IN
367500000X
Certified Registered Nurse Anesthetist
28261167A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28261167C
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0417607
—
OH
05
—
300041938
—
IN
Enumeration date
06/30/2020
Last updated
11/13/2023
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