Healthcare Provider Details

I. General information

NPI: 1427049428
Provider Name (Legal Business Name): ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MED PARK DR SUITE D
WARSAW IN
46580-3285
US

IV. Provider business mailing address

1000 MED PARK DR SUITE D
WARSAW IN
46580-3285
US

V. Phone/Fax

Practice location:
  • Phone: 574-269-8320
  • Fax:
Mailing address:
  • Phone: 574-269-8320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN R SMITH
Title or Position: CEO/TREASURER
Credential:
Phone: 260-436-2416