DR. THOMAS PAUL DETTMER (NPI# 1750519377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750519377 |
| Entity Type | Individual |
| Full Name | DR. THOMAS PAUL DETTMER |
| Credential | PSY.D |
| Practice Address |
6223 Constitution Dr Fort Wayne IN 46804-1517 |
| Mailing Address |
1614 Alabama Ave Fort Wayne IN 46805-5012 |
| Practice Telephone | 2607555896 |
| Mailing Telephone | 2606097007 |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2010-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
39002939A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477548527 | Thomas A Dettmer | Optometrist | 5962 Highway 54, Osage Beach, MO 65065-3338 | 2005-09-14 |
| Street Address |
6223 CONSTITUTION DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-1517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164052791 | Kadlec Consulting Services, LLC | Psychologist | 5525 Oak Valley Pl, Fort Wayne, IN 46845-1836 | 2020-01-23 |
| 1053628248 | Kelly Stewart Hutner | Psychologist | 11143 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845-1728 | 2010-09-09 |
| 1730495813 | Spencer Jenkins Booth | Psychologist | 6526 W Jefferson Blvd, Fort Wayne, IN 46804-6206 | 2010-08-26 |
| 1750509667 | Casey Nelson | Psychologist | 1515 Magnavox Way, Fort Wayne, IN 46804-1533 | 2007-04-23 |
| 1982732491 | Shirley F Shiff | Psychologist | 8424 Victoria Woods Pl, Fort Wayne, IN 46825-6510 | 2007-02-28 |
| 1912080359 | Abigail Dormire Powers | Psychologist | 10311 Dawsons Creek Blvd, Suite F, Fort Wayne, IN 46825-1913 | 2006-10-21 |
| 1376593046 | Wayne James Von Bargen | Psychologist | 1910 Saint Joe Center Rd, Suite 44, Fort Wayne, IN 46825-5000 | 2006-05-11 |
| 1093774796 | Mcgee-lytle Inc | Psychologist | 2020 E Washington Blvd, Suite 650, Fort Wayne, IN 46803-1327 | 2006-03-21 |
| 1043283641 | Jason T. Cook | Psychologist | 7230 Engle Rd, Ste 304, Fort Wayne, IN 46804-2209 | 2006-02-13 |
| 1497737902 | Kevin L. Wieland | Psychologist | 1415 Magnavox Way, Suite 120, Fort Wayne, IN 46804-1565 | 2005-11-18 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on DR. THOMAS PAUL DETTMER.
| 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.