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General NPI Number Information
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NPI Number | 1063460160
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR ORTHOPEDIC AND NERVE SURGERY
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 230 E DAY RD SUITE 130
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City | MISHAWAKA
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State | IN
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Zip | 46545-3408
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Country | US
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Telephone | 574-247-4667
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Fax | 574-271-4458
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Provider Business Mailing Address
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Address Line | 230 E DAY RD SUITE 130
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City | MISHAWAKA
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State | IN
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Zip | 46545
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Country | US
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Telephone | 574-247-4667
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Fax | 574-271-4458
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS GERARD AKRE
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Credential | DO
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Telephone | 574-247-4667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 02002335A
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License Number State | IN
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