Provider Demographics
NPI:1366424616
Name:KATHRYN BARRYE EINHAUS, M.D., P.C.
Entity type:Organization
Organization Name:KATHRYN BARRYE EINHAUS, M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:EINHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-490-2229
Mailing Address - Street 1:10215 AUBURN PARK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-2387
Mailing Address - Country:US
Mailing Address - Phone:260-490-2229
Mailing Address - Fax:260-490-3807
Practice Address - Street 1:10215 AUBURN PARK DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-2387
Practice Address - Country:US
Practice Address - Phone:260-490-2229
Practice Address - Fax:260-490-3807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50004578207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCJ3627OtherRAILROAD MEDICARE
IN15D0912647OtherCLIA
IN200359250AMedicaid
NC6999726Medicaid
NC6999726Medicaid