Fort Wayne Medical Oncology and Hematology Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

60005894 Issued in IN

Legal business name

FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY INC

Practice address

2514 E Dupont Road Suite 100
Fort Wayne, IN 46825-1619

Phone

(260) 484-8830

Fax

(260) 483-1911

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Gary Gize, MD

Title

MD - Owner

Phone

(260) 484-8830

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1639239171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 E DUPONT ROAD SUITE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251619",
            "telephone_number": "260-484-8830",
            "fax_number": "260-483-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 E DUPONT ROAD SUITE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251619",
            "telephone_number": "260-484-8830",
            "fax_number": "260-483-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "GIZE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MD - OWNER",
        "authorized_official_telephone_number": "260-484-8830",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "60005894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100053330",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Wayne Medical Education Program Inc
• Fort Wayne Medical Institute
• Fort Wayne Medical Laboratory Corporation
• Fort Wayne Medical Oncology & Hemat
• Fort Wayne Medical Oncology and Hematology Inc
• Fort Wayne Medical Oncology and Hematology, Inc
• Fort Wayne Mental Health
• Fort Wayne Mental Health Therapy LLC
• Fort Wayne Neurofeedback, LLC
• Fort Wayne Neuropsychology LLC

• Durable Medical Equipment & Medical Supplies in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.