| Jeffrey L Harris, MD | |
|
5050 N Clinton St, Fort Wayne, IN 46825-5886 | |
| (260) 484-8551 | |
| (260) 408-8014 |
| Full Name | Jeffrey L Harris |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 5050 N Clinton St, 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 |
|---|---|---|---|
| 1689673204 | NPI | - | NPPES |
| 200034548 | Other | IN | RAIL ROAD MEDICARE |
| 2147402 | Medicaid | OH | |
| 100362700 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 01041577A (Indiana) | Primary |
| Entity Name | Orthopaedics Northeast Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740268796 PECOS PAC ID: 9234024878 Enrollment ID: O20040405001087 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey L Harris, MD 5052 N Clinton St, Fort Wayne, IN 46825-5822 Ph: (260) 484-8551 | Jeffrey L Harris, MD 5050 N Clinton St, Fort Wayne, IN 46825-5886 Ph: (260) 484-8551 |
Ian R Nelson, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 Fax: 260-436-8585 | |
Dr. John Paul Magno Manalo, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 | |
William H Couch, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 5050 N Clinton Street, Fort Wayne, IN 46825 Phone: 260-484-8551 Fax: 260-484-9603 | |
Dr. George Robert Kolettis, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 | |
Steven Robert Eddy, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 Fax: 260-436-8585 | |
David A Goertzen, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5050 N Clinton St, Fort Wayne, IN 46825 Phone: 260-484-8551 Fax: 260-482-5060 | |
Joseph M Mattox, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5050 N Clinton St, Fort Wayne, IN 46825 Phone: 260-484-8551 Fax: 260-482-5060 |