MEDICARE: DR. ZOEY KAY LOOMIS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT 1825	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410048482	OTHER	CO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588646822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZOEY KAY LOOMIS OD

Provider Business Mailing Address
First Line	:	231 PROSPECT ST
Second Line	:	SUITE B
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3161
Country	:	US
Telephone Number	:	970-867-3937
Fax Number	:	970-867-3037

Provider Business Practice Location Address
First Line	:	231 PROSPECT ST
Second Line	:	SUITE B
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3161
Country	:	US
Telephone Number	:	970-867-3937
Fax Number	:	970-867-3037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	08/20/2009

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