| David K. Wysong Dpm, Pc | |
|
3012 E State Blvd, Fort Wayne, IN 46805-4737 | |
| (260) 471-6830 | |
| (260) 471-6704 |
| Full Name | David K. Wysong Dpm, Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 3012 E State Blvd, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932360468 | NPI | - | NPPES |
| 480033834 | Other | IN | RAILROAD MEDICARE |
| 100081210 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 07000579A (Indiana) | Primary |
| Provider Name | David K Wysong |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114956844 PECOS PAC ID: 8123190113 Enrollment ID: I20080708000623 |
| Mailing Address | Practice Location Address |
|---|---|
| David K. Wysong Dpm, Pc 3012 E State Blvd, Fort Wayne, IN 46805-4737 Ph: (260) 471-6830 | David K. Wysong Dpm, Pc 3012 E State Blvd, Fort Wayne, IN 46805-4737 Ph: (260) 471-6830 |
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