NPI 1518909985

Qhg of Fort Wayne Company LLC

Organisation General Practice Physician Fort Wayne, IN

Practice location

Address: 7333 W Jefferson Blvd, Fort Wayne, IN 46804-6280
Phone: (260) 435-7334
Mailing address: 7100 Commerce Way Suite 180, Brentwood, TN 37027-2829

Authorised official

Name: Debbie T Brewer
Title: Director of Provider Enrollment
Phone: (615) 465-7626

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1518909985
Entity type: Organization
NPI issued: 12 Jun 2006
Record last updated: 27 Feb 2008

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.