Fort Wayne Orthopaedics, LLC

NPI #1104131259 in Angola, Indiana

Provider Information

NPI Number: 1104131259
Entity Type: Organization
Organization Name: Fort Wayne Orthopaedics, LLC
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Aug 13, 2010
Last Updated: Jan 7, 2022

Practice Location

Address: 306 E MAUMEE ST, STE. 304
City: Angola
State: Indiana
ZIP Code: 46703-2035
Phone: (260) 436-8686

Authorized Official

Name: JERALD L. COOPER, MD
Title: PHYSICIAN/OWNER
Phone: (260) 436-8686

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X
Orthopaedic Surgery - Hand Surgery — Hand Surgery	207XS0106X
Orthopaedic Surgery - Orthopaedic Surgery of the Spine — Orthopaedic Surgery of the Spine	207XS0117X
Orthopaedic Surgery - Sports Medicine — Sports Medicine	207XX0005X
Orthopaedic Surgery - Orthopaedic Trauma — Orthopaedic Trauma	207XX0801X
Podiatrist	213E00000X
Podiatrist - Foot Surgery — Foot Surgery	213ES0131X
Physician Assistant	363A00000X
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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