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JAMES C LOOMIS DPM
Foot & Ankle Surgery >> Podiatrist >> Podiatric Medicine & Surgery Service ProvidersRegistrant NPI Number: 1104899103
Individual Registrant: JAMES C LOOMIS DPM
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
322 CHURCH ST JESSUP, PA 18434-1024 US
Tel: 570-383-4958 Fax: 570-383-3018
Tel: 570-383-4958 Fax: 570-383-3018
Contact information for business:
322 CHURCH ST JESSUP, PA 18434-1024 US
Tel: 570-383-4958 Fax: 570-383-3018
Tel: 570-383-4958 Fax: 570-383-3018
Registration Information:
NPI: 1104899103
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 213ES0103X | Podiatric Medicine & Surgery Service Providers Podiatrist Foot & Ankle Surgery | PA | SC-003449-L |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 0012410720003 | PA | 05 |
