Provider Demographics
NPI:1609056779
Name:ALLEN COUNTY OB-GYN ASSOCIATES, PC
Entity type:Organization
Organization Name:ALLEN COUNTY OB-GYN ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:AMECHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-422-7247
Mailing Address - Street 1:800 BROADWAY STE 315
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-2149
Mailing Address - Country:US
Mailing Address - Phone:260-422-7427
Mailing Address - Fax:260-420-5608
Practice Address - Street 1:800 BROADWAY STE 315
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-2149
Practice Address - Country:US
Practice Address - Phone:260-422-7427
Practice Address - Fax:260-420-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040539A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1578568085OtherNPI
IN138640Medicare PIN
IND39287Medicare UPIN