| Dr Thomas P Dykstra, MD | |
|
2200 Randallia Dr, Fort Wayne, IN 46805-4638 | |
| (260) 373-4000 | |
| (260) 482-4442 |
| Full Name | Dr Thomas P Dykstra |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2200 Randallia Dr, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366437410 | NPI | - | NPPES |
| 000000082528 | Other | IN | ANTHEM |
| 000000004849 | Other | MPLAN | |
| 200033350 | Medicaid | IN | |
| 2517940 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 01038525A (Indiana) | Primary |
| Entity Name | Professional Emergency Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144215096 PECOS PAC ID: 2769384213 Enrollment ID: O20040123000999 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas P Dykstra, MD 3640 New Vision Dr, Suite A, Fort Wayne, IN 46845-1717 Ph: (260) 482-4440 | Dr Thomas P Dykstra, MD 2200 Randallia Dr, Fort Wayne, IN 46805-4638 Ph: (260) 373-4000 |
Dr. Danyelle R Aber, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 11109 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-266-1000 | |
Amy Souers, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 11109 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-266-1000 | |
Aeden J Ligon, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 9216 Crystal Spring Dr, Fort Wayne, IN 46804 Phone: 765-480-9828 | |
Albert V Emilian, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 10343 Dawsons Creek Blvd, Suite A, Fort Wayne, IN 46825 Phone: 260-203-9600 Fax: 260-739-6167 | |
Dr. Janardhanan V Davy, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 7950 W Jefferson Blvd Ste 2121, Fort Wayne, IN 46804 Phone: 260-435-2937 | |
Dr. Elmer Toliver, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2121 Lake Ave, Fort Wayne, IN 46805 Phone: 260-426-5431 | |
Bruce Sowers, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-435-7001 |