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General NPI Number Information
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NPI Number | 1386606911
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA CENTER, PC
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 7222 ENGLE ROAD
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City | FORT WAYNE
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State | IN
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Zip | 46804-2222
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Country | US
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Telephone | 260-432-5005
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Fax | 260-432-6003
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Provider Business Mailing Address
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Address Line | 7222 ENGLE ROAD
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City | FORT WAYNE
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State | IN
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Zip | 46804-2222
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Country | US
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Telephone | 260-432-5005
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Fax | 260-432-6003
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | JANEAN FARRELL
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Credential |
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Telephone | 260-432-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 50003931A
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License Number State | IN
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