Individual
THOMAS B KLOOSTERBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
845 PARKSIDE ST, RIPON, WI 54971-8505
(920) 748-3101
(920) 926-8370
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25277
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30563300
—
WI
Enumeration date
02/28/2006
Last updated
12/15/2020
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