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NPI 1013188291 · live from the CMS NPI Registry

Gage Manning Caudell, D.P.M.

Podiatrist, Foot & Ankle Surgery in Fort Wayne, IN. National Provider Identifier 1013188291, active.

NPI record

NPI1013188291 Type 1 · individual
StatusActive
Primary specialtyPodiatrist, Foot & Ankle Surgery 213ES0103X
Practice location7601 W Jefferson Blvd, Fort Wayne, IN 46804
Practice phone260-436-8686
Mailing addressPo Box 2526, Fort Wayne, IN 46801
EnumeratedMarch 17, 2008
Last updatedNovember 7, 2016
Sole proprietorNo

Taxonomies and licenses

TaxonomyCodeLicense
Podiatrist, Foot & Ankle Surgery primary213ES0103X07001098A (IN)
Podiatrist, Foot & Ankle Surgery213ES0103X36003452 (OH)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.