| NPI | 1104131259 |
|---|---|
| Doing Business As | FORT WAYNE ORTHOPEDICS, LLC |
| Entity Type | Organization |
| Authorized Contact | JERALD L. COOPER Physician/Owner 260-436-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 50002482) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 50002482) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: IN 50002482) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IN 50002482) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 50002482) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: IN 50002482) | |
| 213E00000X Podiatrist (Licence: IN 50002482) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: IN 50002482) | |
| 363A00000X Physician Assistant (Licence: IN 50002482) | |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2022-01-07 |