Douglas J Van Putten MD Facs Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01039408 Issued in IN

Legal business name

DOUGLAS J VAN PUTTEN MD FACS INC

Practice address

8865 W 400 N
Michigan City, IN 46360-9222

Phone

(330) 773-3544

Fax

(330) 773-3698

NPI assigned

Feb 26, 2008

Last updated

Jul 15, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Douglas J Vanputten, MD

Title

President

Phone

(219) 872-7546

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1548439219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895315",
            "telephone_number": "330-773-3544",
            "fax_number": "330-773-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8865 W 400 N",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609222",
            "telephone_number": "330-773-3544",
            "fax_number": "330-773-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS J VAN PUTTEN MD FACS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "VANPUTTEN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-872-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01039408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200922580B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200922580A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.