MEDICARE: ALLIED PHYSICIANS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208100000X	Physical Medicine & Rehabilitation Physician
2	2084N0400X	Neurology Physician
3	363A00000X	Physician Assistant
4	363L00000X	Nurse Practitioner
5	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1265601041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED PHYSICIANS INC

Provider Business Mailing Address
First Line	:	7956 W JEFFERSON BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4140
Country	:	US
Telephone Number	:	260-436-2416
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 E DUPONT RD STE 120
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1609
Country	:	US
Telephone Number	:	260-436-2416
Fax Number	:	260-436-6936

Authorized Official
Title or Position	:	CEO
Name	:	DONALD RAY SHOOK
Credential	:
Telephone Number	:	260-399-4704

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	10/17/2019

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Directions to “ALLIED PHYSICIANS INC ” Practice Location

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