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General NPI Number Information
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NPI Number | 1487809588
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Entity Type | Organization
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Legal Business Name | ASSOCIATED SURGEONS AND PHYSICIANS, LLC
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 06/30/2016
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Provider Practice Location Address
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Address Line | 2518 E DUPONT RD
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City | FORT WAYNE
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State | IN
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Zip | 46825-1675
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Country | US
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Telephone | 260-432-4400
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Fax | 260-969-6898
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Provider Business Mailing Address
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Address Line | 2518 E DUPONT RD
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City | FORT WAYNE
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State | IN
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Zip | 46825-1675
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Country | US
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Telephone | 260-432-4400
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Fax | 260-969-6898
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Authorized Official
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Title or Position | CFO
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Name | MS. TRISH WARREN
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Credential |
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Telephone | 260-432-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | IN
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