OPHTHALMOLOGY CONSULTANTS OF FORT WAYNE PC NPI 1194708792

NPI Information

OPHTHALMOLOGY CONSULTANTS OF FORT WAYNE PC is an ambulatory surgical clinic center in Fort Wayne, IN. OPHTHALMOLOGY CONSULTANTS OF FORT WAYNE PC NPI is 1194708792. The provider is registered as an organization entity type.
The provider Is Doing Business As Surgery Center Of Ophthalmology Consultants.

The provider's business location address is:

7232 ENGLE RD
FORT WAYNE, IN
ZIP 46804-222
Phone: (260) 436-7205
Fax: (260) 432-1339

The provider's authorized official is Tricia Pieper .
The authorized official title is Practice Manager and has the following contact phone number (260) 436-7205.

The CLIA number assigned to this NPI record is 15D2179842 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/29/2005 and was last updated on 8/5/2020.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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