Provider Demographics
NPI:1326763491
Name:INDY WOUND CENTER FOR LIMB PRESERVATION & RECONSTRUCTION LLC
Entity Type:Organization
Organization Name:INDY WOUND CENTER FOR LIMB PRESERVATION & RECONSTRUCTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:765-618-2792
Mailing Address - Street 1:8325 S EMERSON AVE STE B1
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8559
Mailing Address - Country:US
Mailing Address - Phone:317-742-6575
Mailing Address - Fax:866-222-7033
Practice Address - Street 1:8325 S EMERSON AVE STE B1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8559
Practice Address - Country:US
Practice Address - Phone:317-742-6575
Practice Address - Fax:866-222-7033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty