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NPI Code Detail

MEDICARE: DR. JASON R UMMEL D.O.

MEDICARE: DR. JASON R UMMEL D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician20A15379CA
2390200000XStudent in an Organized Health Care Education/Training Program
3207X00000XOrthopaedic Surgery Physician02005947AIN

General Provider Information

NPI Number : 1063892875
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON R UMMEL D.O.
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1655 N CASS ST
Second Line :
City : WABASH
State : IN
Zip : 46992-9416
Country : US
Telephone Number : 260-569-2983
Fax Number : 260-569-2990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2015
Last Update Date : 07/12/2023

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Directions to “ DR. JASON R UMMEL D.O.” Practice Location

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