Kolettis, George T

Kolettis, George T is an individual health care provider with primary practice located at 7601 W Jefferson Blvd , Fort Wayne IN 46804-4133. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery is his primary health care specialty. Kolettis, George T can be contacted via phone (260) 436-8686.

Contact Information

Primary practice address
7601 W Jefferson Blvd Fort Wayne IN 46804-4133
Phone: (260) 436-8686
Fax: (260) 436-8585
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 4301062980 Michigan
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 01071673A Indiana
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X 01071673A Indiana

Profile Details

NPI number 1295714608
LBN Legal business name Kolettis, George T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Nov 7th, 2016 - about 10 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 1295714608 NPPES
Other 000000784327 ANTHEM
MEDICAID 201117660 ANTHEM
Other P01128176 ANTHEM

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