Individual
DR. BRIAN L VAN HOOZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1505 MILL ST, NEW LONDON, WI 54961-2187
(920) 982-7900
(920) 982-7995
Mailing address
PO BOX 96, NEW LONDON, WI 54961-0096
(920) 982-7900
(920) 982-7995
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
32699
WI
207Q00000X
Family Medicine Physician
Primary
32699
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
05
—
30054700
—
WI
01
—
390848401050
CMH ANTHEM
WI
Enumeration date
10/19/2006
Last updated
09/20/2021
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