George T Kolettis
Orthopaedic Surgeon Adult Reconstructive Orthopaedic Surgeon
7601 W Jefferson Blvd
Fort Wayne
, Indiana 46804-4133
George T Kolettis
Orthopaedic Surgeon Adult Reconstructive Orthopaedic Surgeon
7601 W Jefferson Blvd
Fort Wayne
, Indiana 46804-4133
(260) 436-8585
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About
Features
Specialties
- Orthopaedic Surgeon
- Adult Reconstructive Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- George T Kolettis
- Po Box 2526
- Fort Wayne, IN
- Zip : 46801-2526
- Fax : (260) 436-8585
- Phone : (260) 436-8686
Second Address
- George T Kolettis
- 7601 W Jefferson Blvd
- Fort Wayne, IN
- Zip : 46804-4133
- Fax : (260) 436-8585
- Phone : (260) 436-8686
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgeon | 01071673A | IN |
| N | 207X00000X | Orthopaedic Surgeon | 4301062980 | MI |
| Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 01071673A | IN |
National Provider Identifier
| NPI | 1295714608 |
|---|---|
| Provider Name | George T Kolettis |
| First Address | Fort Wayne, IN 46801-2526 |
| Second Address | Fort Wayne, IN 46804-4133 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/01/2006 |
| Last Update Date | 07/11/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000784327 | ANTHEM (01) | |
| 201117660 | (05) | IN |
| P01128176 | RAILROAD MEDICARE (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.