Garrett H Bastin, DO | |
10101 Ernst Rd Ste 1200, Roanoke, IN 46783-9711 | |
(260) 234-5400 | |
(260) 234-5410 |
Full Name | Garrett H Bastin |
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Gender | Male |
Speciality | Family Medicine |
Location | 10101 Ernst Rd Ste 1200, Roanoke, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548837255 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 11021719A (Indiana) | Secondary |
207Q00000X | Family Medicine | 02006843A (Indiana) | Primary |
Entity Name | Indiana University Health Fort Wayne Physicians, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316550445 PECOS PAC ID: 5193138527 Enrollment ID: O20210104001512 |
Mailing Address | Practice Location Address |
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Garrett H Bastin, DO 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 Ph: (260) 423-2675 | Garrett H Bastin, DO 10101 Ernst Rd Ste 1200, Roanoke, IN 46783-9711 Ph: (260) 234-5400 |
Jeffrey L Witt, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10101 Ernst Rd Ste 1200, Roanoke, IN 46783 Phone: 260-234-5400 Fax: 260-235-5410 | |
Theppanya Ka Keolasy, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 577 Geiger Dr Ste C, Roanoke, IN 46783 Phone: 260-672-5950 Fax: 260-672-0939 | |
Dr. Amy H Welker, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 577 Geiger Dr, Suite C, Roanoke, IN 46783 Phone: 260-672-5950 Fax: 260-672-0939 | |
Stephanie S Kidd, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10101 Ernst Rd Ste 1200, Roanoke, IN 46783 Phone: 260-234-5400 Fax: 260-235-5410 | |
Mark A King, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10101 Ernst Rd Ste 1100, Roanoke, IN 46783 Phone: 260-234-5400 Fax: 260-234-5410 | |
Catherine C Moffitt, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10101 Ernst Rd Ste 1200, Roanoke, IN 46783 Phone: 260-234-5400 Fax: 260-234-5410 |