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EAR NOSE & THROAT ASSOCIATES PC NPI 1851377691


NPI Information

NPI: 1851377691
Provider Name: EAR, NOSE & THROAT ASSOCIATES, PC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 15D2019011

Address:
10021 DUPONT CIRCLE CT
FORT WAYNE, IN
ZIP 46825
Phone: (260) 426-8117
Get Directions

EAR, NOSE & THROAT ASSOCIATES, PC is an otolaryngology in Fort Wayne, IN. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. EAR, NOSE & THROAT ASSOCIATES, PC NPI is 1851377691. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10021 DUPONT CIRCLE CT
FORT WAYNE, IN
ZIP 46825-604
Phone: (260) 426-8117
Fax: (260) 420-0817

The provider's authorized official is Brian D. Herr .
The authorized official title is Partner/president and has the following contact phone number (260) 426-8117.

The CLIA number assigned to this NPI record is 15D2019011 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2005 and was last updated on 1/8/2013.


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
1207Y00000XOtolaryngology50000001AINDIANAYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10751833MEDICAIDOHIO
2100050300MEDICAIDINDIANA
3047930MEDICARE PININDIANA
4CB0096MEDICARE PININDIANA
5EA9302361MEDICARE PINOHIO

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

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