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Individual

DR. WILLIAM A LOE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11123 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845
(260) 425-6100
(260) 425-6105
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
01079883A
IN
2086S0120X
Pediatric Surgery Physician
016509
LA
2086S0120X
Pediatric Surgery Physician
52366
SC
2086S0120X
Pediatric Surgery Physician
62296
TN
2086S0120X
Pediatric Surgery Physician
Primary
ME111827
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1330035
LA
Enumeration date
04/25/2006
Last updated
01/16/2025
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