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General NPI Number Information
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NPI Number | 1376693770
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Entity Type | Individual
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Provider Name | JOHN LLOYD LOEWEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 615 WASHINGTON AVE
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City | NIAGARA
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State | WI
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Zip | 54151-1213
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Country | US
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Telephone | 715-251-3104
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Fax | 715-251-1693
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Provider Business Mailing Address
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Address Line | 615 WASHINGTON AVE
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City | NIAGARA
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State | WI
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Zip | 54151-1213
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Country | US
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Telephone | 715-251-3104
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Fax | 715-251-1693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20876 020
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License Number State | WI
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