Thomas W. Herendeen
Otolaryngology/Facial Plastic Surgery
10021 Dupont Circle Ct
Fort Wayne
, Indiana 46825-1604
Thomas W. Herendeen
Otolaryngology/Facial Plastic Surgery
10021 Dupont Circle Ct
Fort Wayne
, Indiana 46825-1604
(260) 420-0817
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About
Features
Specialties
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Thomas W. Herendeen
- 10021 Dupont Circle Ct
- Fort Wayne, IN
- Zip : 46825-1604
- Fax : (260) 420-0817
- Phone : (260) 426-8117
Second Address
- Thomas W. Herendeen
- 10021 Dupont Circle Ct
- Fort Wayne, IN
- Zip : 46825-1604
- Fax : (260) 420-0817
- Phone : (260) 426-8117
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 01041576A | IN |
National Provider Identifier
| NPI | 1356333272 |
|---|---|
| Provider Name | Thomas W. Herendeen |
| First Address | Fort Wayne, IN 46825-1604 |
| Second Address | Fort Wayne, IN 46825-1604 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2005 |
| Last Update Date | 20/06/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200163210 | (05) | IN |
| 2067043 | (05) | OH |
| G03607 | (02) | IN |
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.