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Individual

DR. THOMAS R KOMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1800 LAWRENCE DR, DE PERE, WI 54115-9108
(920) 983-3220
(920) 983-3226
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
534-025
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0256660001
MEDICARE DME
WI
01
41732500
MEDICAID DME
WI
05
43205900
WI
Enumeration date
08/17/2005
Last updated
05/17/2023
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