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Dr. Jonathan Detommaso, DPM
Foot & Ankle Surgery Podiatrist in Fort Wayne, Indiana
NPI 1033476304

Jonathan Detommaso is a Foot & Ankle Surgery Podiatrist based in Fort Wayne, IN and is specialized in Foot & Ankle Surgery. Jonathan Detommaso practices in Fort Wayne, IN and has the professional credentials of DPM. The NPI Number for Jonathan Detommaso is 1033476304 and holds a License No. 07001204A (Indiana).

The current practice location address for Jonathan Detommaso is 7601 W Jefferson Blvd, Fort Wayne, IN and can be reached out via phone at 260-436-8686 and via fax at 260-436-8585.

Location: 7601 W Jefferson Blvd, Fort Wayne, IN, 46801-2526
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Provider Profile Details
NPI Number
1033476304
Provider Name
Jonathan Detommaso
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
7601 W Jefferson Blvd, Fort Wayne, IN, 46801-2526
Phone Number
260-436-8686
Fax Number
260-436-8585
Provider Enumeration Date
04/11/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P01524125 01 IN RAILROAD MEDICARE
201289140 05 IN
000000934131 01 IN ANTHEM
institution
Provider Business Practice Location Address Details
Address
7601 W Jefferson Blvd
City
State
Zip
46804-4133
Phone Number
260-436-8686
Fax Number
260-436-8585
person
Provider Business Mailing Address Details
Address
7601 W Jefferson Blvd
City
State
Zip
46804-4133
Phone Number
260-436-8686
Fax Number
260-436-8585
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
License No.
07001204A (Indiana)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
07001204A (Indiana)
Definition
Definition to come...
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