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Contact Information

FORT WAYNE RADIOLOGY ASSOCIATES LLC
3707 NEW VISION DR
FORT WAYNE, IN46845
 Phone: 260-471-9466
 Fax: 260-484-5919
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for FORT WAYNE RADIOLOGY ASSOCIATES LLC · (Female)

NPI Number 1063475861
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2006
Last updated 07/10/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN Medicaid 200176030A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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