IndividualActive
Derek Ellingson, D.O.
NPI 1487848644 · Anatomic Pathology & Clinical Pathology Physician · Fort Wayne, IN
Provider details
- NPI number
- 1487848644
- Entity type
- Individual
- Primary specialty
- Anatomic Pathology & Clinical Pathology PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- DO05260 (IA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone: (260) 435-7001
Approximate (ZIP-level) locationGet directions
Mailing address
1010 Airpark Center Dr
Nashville, TN 37217-5200
Registry dates
- Enumerated
- 2007-08-30
- Last updated
- 2021-08-25
- Certified
- 2021-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.