Individual provider · Type 1 NPI

Jonathan Detommaso, DPM

Foot & Ankle Surgery Podiatrist · Fort Wayne, IN

NPI number 1033476304 Active

Practice location

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Call (260) 436-8686 Map

Fax (260) 436-8585

Mailing address

PO Box 2526
Fort Wayne, IN 46801-2526

Specialties and licenses

TaxonomyCodeLicense
Podiatrist 213E00000X07001204A (IN)
Foot & Ankle Surgery Podiatrist Primary 213ES0103X07001204A (IN)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1033476304

Jonathan Detommaso, DPM's National Provider Identifier is 1033476304, issued on Apr 11, 2012. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Fort Wayne, IN. The record was last updated on Nov 7, 2016.