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NPI Code Detail

MEDICARE: ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROSURGERY

MEDICARE: ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROSURGERY
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
1207T00000XNeurological Surgery Physician

General Provider Information

NPI Number : 1255322103
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROSURGERY
Provider Business Mailing Address
First Line : 2622 LAKE AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-5410
Country : US
Telephone Number : 260-460-3100
Fax Number :
Provider Business Practice Location Address
First Line : 2622 LAKE AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-5410
Country : US
Telephone Number : 260-460-3100
Fax Number :
Authorized Official
Title or Position : CEO/TREASURER
Name : STEPHEN R SMITH
Credential :
Telephone Number : 260-436-2416
Provider Enumeration Date : 10/31/2005
Last Update Date : 08/22/2020

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Directions to “ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROSURGERY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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