Todd Lee Deturk in Fort Wayne - Physician Assistant
Todd Lee Deturk - NPI 1558332403
Todd Lee Deturk is a Physician Assistant in Fort Wayne, Indiana. Todd Lee Deturk practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Todd Lee Deturk is 1558332403. The last update date is 2016-11-07.
Todd Lee Deturk's current location address is Po Box 2526, Fort Wayne, Indiana. You can contact this provider via phone number 2604368686 and fax number 2604368585. The mailing address for Todd Lee Deturk is Po Box 2526, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Todd Lee Deturk |
|---|---|
| Address | Po Box 2526, Fort Wayne, Indiana |
| Phone Number | 2604368686 |
| Fax Number | 2604368585 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1558332403 |
|---|---|
| Provider Enumeration Date | 2006-01-30 |
| Last Updated Date | 2016-11-07 |
Provider Mailing Address Detail
| Address | Po Box 2526 |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468012526 |
| Phone Number | 2604368686 |
| Fax Number | 2604368585 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 10000810A |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| OPR | IN | -- | |
| 622050 | ANTHEM |
Post Comment/ Review Below
What is the unique identification code assigned to Todd Lee Deturk by the Centers for Medicare & Medicaid Services?
The Todd Lee Deturk has been issued the NPI (National Provider Identifier) 1558332403. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Todd Lee Deturk located?
The Todd Lee Deturk is located at Po Box 2526, Fort Wayne, IN 468012526.
What is Todd Lee Deturk's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Todd Lee Deturk is Physician Assistant, and the corresponding taxonomy classification code for this specialized field is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1558332403 to Todd Lee Deturk?
The Todd Lee Deturk received its 1558332403 assignment from the Centers for Medicare & Medicaid Services on 2006-01-30.
When was the Todd Lee Deturk's information last updated?
The Todd Lee Deturk's information was last updated on 2016-11-07.
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