Indiana Epilepsy And Child Neurology, Inc. | |
4310 Lake Ave Fort Wayne IN 46815-7222 | |
(260) 426-9996 | |
(260) 426-9996 |
Full Name | Indiana Epilepsy And Child Neurology, Inc. |
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Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
Location | 4310 Lake Ave, Fort Wayne, Indiana |
Authorized Official Name and Position | Don Stauffer (VICE PRESIDENT) |
Authorized Official Contact | 2604269996 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Indiana Epilepsy And Child Neurology, Inc. 4310 Lake Ave Fort Wayne IN 46815-7222 Ph: (260) 426-9996 | Indiana Epilepsy And Child Neurology, Inc. 4310 Lake Ave Fort Wayne IN 46815-7222 Ph: (260) 426-9996 |
NPI Number | 1871668582 |
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Provider Enumeration Date | 11/21/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1871668582 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
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