Individual
DR. HENRY J LOOMANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
835 S MAIN ST, SUITE 1, OCONTO FALLS, WI 54154-1282
(920) 846-8187
(920) 846-2073
Mailing address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241
(920) 846-3444
(920) 846-2073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35770
WI
207RI0200X
Infectious Disease Physician
35770-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1174630628
BCBS
WI
01
—
1326349135
CMH SB NPI
WI
01
—
1467583096
CLINIC NPI
WI
01
—
1851477913
CMH NPI
WI
05
—
207R00000X
—
WI
01
—
390806395041
CHAMPUS
WI
Enumeration date
08/23/2006
Last updated
09/02/2014
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