Individual
THOMAS B HUIZENGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 W RIVER WOODS PARKWAY, STE 130, GLENDALE, WI 53212-1010
(414) 961-0304
(414) 961-2061
Mailing address
3970 N OAKLAND AVE, SUITE 300, MILWAUKEE, WI 53211-2265
(414) 961-0304
(414) 961-2061
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
49399
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34874500
—
WI
Enumeration date
07/13/2006
Last updated
10/23/2019
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