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General NPI Number Information
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NPI Number | 1811970858
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Entity Type | Organization
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Legal Business Name | KNEE & SHOULDER CENTER, INC.
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 2510 E DUPONT RD SUITE 206
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City | FORT WAYNE
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State | IN
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Zip | 46825-1600
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Country | US
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Telephone | 260-497-8855
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Fax | 260-497-8866
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Provider Business Mailing Address
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Address Line | 2510 E DUPONT RD SUITE 206
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City | FORT WAYNE
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State | IN
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Zip | 46825-1600
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Country | US
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Telephone | 260-497-8855
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Fax | 260-497-8866
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | WILLIAM M. RUTLEDGE
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Credential | M.D.
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Telephone | 260-497-8855
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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 |
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License Number State |
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