NPI 1013500271

Premise Health of Indiana Medical PC

Organisation Occupational Medicine Clinic/Center Fort Wayne, IN

Practice location

Address: 4350 Airport Expressway, Fort Wayne, IN 46509
Phone: (260) 434-5053
Fax: (260) 434-5413
Mailing address: 5500 Maryland Way STE 120, Brentwood, TN 37027-4993

Authorised official

Name: Jon Leizman
Title: President
Phone: (615) 468-6270

Registered specialties

Occupational Medicine Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QX0100X

Other Clinic/Center providers in Indiana →

Registry record

NPI: 1013500271
Entity type: Organization
NPI issued: 18 Feb 2021
Record last updated: 29 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.