Organization Name: | JAMES C LOOMIS DPM |
NPI Number: | 1891979654 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES C LOOMIS (OWNER) |
Mailing Address: | 322 Church St Jessup |
State: | PA US |
Postal Code: | 184341024 |
Phone Number: | 5703834958 |
Fax Number: | 5703833018 |
NPI Enumeration Date: | 12/28/2007 |
NPI Last Update Date: | 12/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | SC003449L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |