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NPI Code Detail

MEDICARE: ORTHOPAEDICS NORTHEAST, PC

MEDICARE: ORTHOPAEDICS NORTHEAST, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies50001907AIN

General Provider Information

NPI Number : 1144209115
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOPAEDICS NORTHEAST, PC
Provider Business Mailing Address
First Line : 5050 N CLINTON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5822
Country : US
Telephone Number : 260-484-8551
Fax Number : 260-484-9603
Provider Business Practice Location Address
First Line : 1500 PROVIDENT DR
Second Line : SUITE B
City : WARSAW
State : IN
Zip : 46580-3291
Country : US
Telephone Number : 574-269-8301
Fax Number : 574-269-8302
Authorized Official
Title or Position : PRESIDENT
Name : JOHN C PRITCHARD
Credential : MD
Telephone Number : 260-484-8551
Provider Enumeration Date : 01/10/2006
Last Update Date : 06/28/2010

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Directions to “ORTHOPAEDICS NORTHEAST, PC ” Practice Location

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