| Dr Dominick Detommaso, DPM | |
| 
					7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133  | |
| (260) 436-8686 | |
| (260) 436-8585 | 
| Full Name | Dr Dominick Detommaso | 
|---|---|
| Gender | Male | 
| Speciality | Podiatrist - Foot & Ankle Surgery | 
| Location | 7601 W Jefferson Blvd, Fort Wayne, Indiana | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013910041 | NPI | - | NPPES | 
| 100053980A | Medicaid | IN | |
| 00000089407 | Other | ANTHEM | |
| 200021084 | Other | RAILROAD MEDICARE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 07000410A (Indiana) | Primary | 
| 213E00000X | Podiatrist | 07000410A (Indiana) | Secondary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Dominick Detommaso, DPM 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 Ph: (260) 436-8686  | Dr Dominick Detommaso, DPM 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 Ph: (260) 436-8686  | 
Lafayette Foot And Ankle Clinic Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2700 Lafayette St Ste 230, Fort Wayne, IN 46806 Phone: 260-458-9953 Fax: 260-458-9238  | |
Lafayette Foot And Ankle Clinic Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 2700 Lafayette St, Suite 100, Fort Wayne, IN 46806 Phone: 260-458-9953 Fax: 260-458-9238  | |
Gage Manning Caudell, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 Fax: 260-436-8585  | |
Dr. Jonathan Detommaso, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 Fax: 260-436-8585  | |
Toes R Us Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6200 Bluffton Rd, Fort Wayne, IN 46809 Phone: 260-747-5572 Fax: 260-747-8392  | |
Dr. David K Wysong, DPM Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 3012 E State Blvd, Fort Wayne, IN 46805 Phone: 260-471-6830 Fax: 260-471-6704  |