Provider Demographics
NPI:1376835926
Name:FINKLEA, AUSTIN J (DO)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:J
Last Name:FINKLEA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 W JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-4140
Mailing Address - Country:US
Mailing Address - Phone:260-434-6377
Mailing Address - Fax:260-434-6389
Practice Address - Street 1:1026 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-3614
Practice Address - Country:US
Practice Address - Phone:260-919-3880
Practice Address - Fax:260-919-3882
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019257390200000X
IN02004623A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN02004623AOtherLICENSE