DR. DAVID K WYSONG (NPI# 1114956844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114956844 |
| Entity Type | Individual |
| Full Name | DR. DAVID K WYSONG |
| Credential | DPM |
| Practice Address |
3012 E State Blvd Fort Wayne IN 46805-4737 |
| Practice Telephone | 2604716830 |
| Practice Fax Number | 2604716704 |
| Mailing Telephone | 2604716830 |
| Mailing Fax Number | 2604716704 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-06-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 07000579 | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100081210 | 05 |
| Street Address |
3012 E STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932360468 | David K. Wysong Dpm, PC | Podiatrist | 3012 E State Blvd, Fort Wayne, IN 46805-4737 | 2008-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417337353 | Hazim Ibrahim | Podiatrist | 7527 Thoroughbred Dr Apt 3d, Fort Wayne, IN 46804 | 2015-06-05 |
| 1760683593 | Toes R Us, Inc. | Podiatrist | 6200 Bluffton Rd, Fort Wayne, IN 46809-2260 | 2007-05-30 |
| 1871605147 | Dennis John Chubinski | Podiatrist | 8028 Carnegie Blvd., 400, Fort Wayne, IN 46804-5788 | 2006-08-31 |
| 1235182643 | Richard M. Hilker, Dpm, P.C. | Podiatrist | 10323 Dawsons Creek Blvd, Bldg. 10-c, Fort Wayne, IN 46825-1910 | 2006-05-18 |
| 1134104474 | Lynn H Stafford | Podiatrist | 7559 W Jefferson Blvd, Fort Wayne, IN 46804-4131 | 2005-12-09 |
| 1487637377 | Richard M Hilker | Podiatrist | 10323 Dawsons Creek, Bldg 10 C, Fort Wayne, IN 46825-1910 | 2005-11-23 |
| 1508867177 | Gary Michael Torkeo | Podiatrist | 4011 W Jefferson Blvd, Suite 175, Fort Wayne, IN 46804-6853 | 2005-08-09 |
| 1346247061 | Michael Steven Worpell | Podiatrist | 1234 E Dupont Rd, 2 1, Fort Wayne, IN 46825-1545 | 2005-07-07 |
| 1760486393 | Lincoln Pedic Clinic, Inc. | Podiatrist | 12311 Autumn Breeze Dr, Fort Wayne, IN 46845-9111 | 2005-06-10 |
| 1124021100 | Karen F Sloane | Podiatrist | 2121 Lake Ave, Fort Wayne, IN 46805-5100 | 2005-05-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on DR. DAVID K WYSONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.