Wysong, David K

Wysong, David K is an sole proprietor health care provider with primary practice located at 3012 E State Blvd , Fort Wayne IN 46805-4737. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Wysong, David K can be contacted via phone (260) 471-6830.

Contact Information

Primary practice address
3012 E State Blvd Fort Wayne IN 46805-4737
Fax: (260) 471-6704
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 07000579 Indiana

Profile Details

NPI number 1114956844
LBN Legal business name Wysong, David K
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2006
Last updated Jun 13th, 2008 - about 16 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 1114956844 NPPES
Indiana MEDICAID 100081210

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