Provider Demographics
NPI:1891846283
Name:ANALEPTIC ASSOCIATES INC
Entity Type:Organization
Organization Name:ANALEPTIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OTIS
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:ORR III
Authorized Official - Suffix:
Authorized Official - Credentials:DPM DC
Authorized Official - Phone:260-484-9321
Mailing Address - Street 1:5015 RIVIERA CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-5805
Mailing Address - Country:US
Mailing Address - Phone:260-484-9321
Mailing Address - Fax:260-484-9321
Practice Address - Street 1:5015 RIVIERA CT
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-5805
Practice Address - Country:US
Practice Address - Phone:260-484-9321
Practice Address - Fax:260-484-9321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000376A111N00000X
IN07000302A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100049840AMedicaid
IN000000082948OtherPODIATRY ANTHEN
IN000000082947OtherCHIROPRACTIC ANTHEM
IN057080Medicare ID - Type UnspecifiedCHIROPRACTIC
IN100049840AMedicaid