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FORT WAYNE PHYSICAL MEDICINE P C NPI 1083833297


NPI Information

NPI: 1083833297
Provider Name: FORT WAYNE PHYSICAL MEDICINE P C

Doing Business As: FORT WAYNE PHYSICAL MEDICINE

Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 15D2081700

Address:
5750 COVENTRY LN
SUITE 101
FORT WAYNE, IN
ZIP 46804
Phone: (260) 436-9337
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FORT WAYNE PHYSICAL MEDICINE P C is a pain medicine physical medicine rehabilitation in Fort Wayne, IN. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. FORT WAYNE PHYSICAL MEDICINE P C NPI is 1083833297. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fort Wayne Physical Medicine.

The provider's business location address is:

5750 COVENTRY LN
SUITE 101
FORT WAYNE, IN
ZIP 46804-166
Phone: (260) 436-9337
Fax: (260) 436-9626

The provider's authorized official is Mark V Reecer .
The authorized official title is Owner and has the following contact phone number (260) 436-9337.

The CLIA number assigned to this NPI record is 15D2081700 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 10/5/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12081P2900XPhysical Medicine & RehabilitationPain MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.