NPI 1033476304

Jonathan Detommaso, DPM

Practitioner Foot & Ankle Surgery Podiatrist Fort Wayne, IN

Practice location

Address: 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133
Phone: (260) 436-8686
Fax: (260) 436-8585
Mailing address: PO Box 2526, Fort Wayne, IN 46801-2526

Registered specialties (2)

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 07001204A (IN)

Other Podiatrist providers in Indiana →

Podiatrist

Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 07001204A (IN)

Registry record

NPI: 1033476304
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Apr 2012
Record last updated: 7 Nov 2016

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.