MEDICARE: INDIANA ORTHOPEDICS, INC

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
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	80000142	OTHER	IN	BC/BS HMO IL
2	000000097284	OTHER	IN	ANTHEM BC/BS

General Provider Information

NPI Number	:	1639174873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIANA ORTHOPEDICS, INC

Provider Business Mailing Address
First Line	:	437 N BROAD ST
Second Line	:
City	:	GRIFFITH
State	:	IN
Zip	:	46319-2223
Country	:	US
Telephone Number	:	219-924-2044
Fax Number	:	219-924-2109

Provider Business Practice Location Address
First Line	:	437 N BROAD ST
Second Line	:
City	:	GRIFFITH
State	:	IN
Zip	:	46319-2223
Country	:	US
Telephone Number	:	219-924-2044
Fax Number	:	219-924-2109

Authorized Official
Title or Position	:	PRESIDENT/ORTHOTIST/PROSTHETIST
Name	:	MR. KENNETH J FURTO
Credential	:	C.P.O.
Telephone Number	:	219-924-2044

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	08/22/2020

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Directions to “INDIANA ORTHOPEDICS, INC ” Practice Location

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