Dedoes, Jason D

Dedoes, Jason D is an individual health care provider with primary practice located at 213 Fairview Blvd , Kendallville IN 46755-2988. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Dedoes, Jason D can be contacted via phone (260) 347-2833.

Contact Information

Primary practice address
213 Fairview Blvd Kendallville IN 46755-2988
Phone: (260) 347-2833
Fax: (260) 668-7563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X T13-2008 Texas
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 07001105A Indiana

Profile Details

NPI number 1851536023
LBN Legal business name Dedoes, Jason D
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2008
Last updated Oct 20th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851536023 NPPES
Indiana MEDICAID 201002160

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