| 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. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 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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