Provider Demographics
NPI:1154721876
Name:DALE H AESCHLIMAN MD INC
Entity type:Organization
Organization Name:DALE H AESCHLIMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:H
Authorized Official - Last Name:AESCHLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-441-3253
Mailing Address - Street 1:5717 S ANTHONY BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46806-3386
Mailing Address - Country:US
Mailing Address - Phone:260-441-3253
Mailing Address - Fax:260-441-3214
Practice Address - Street 1:5717 S ANTHONY BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46806-3386
Practice Address - Country:US
Practice Address - Phone:260-441-3253
Practice Address - Fax:260-441-3214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01025296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty