Dr. Glen R. Van Loon
Endocrinologist (Diabetes Doctor)
619 Old Symsonia Rd Ste C
Benton
, Kentucky 42025-1365
Dr. Glen R. Van Loon
Endocrinologist (Diabetes Doctor)
619 Old Symsonia Rd Ste C
Benton
, Kentucky 42025-1365
(270) 527-7882
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About
Features
Specialties
- Endocrinologist (Diabetes Doctor)
Languages spoken
- English
Location
First Address
- Dr. Glen R. Van Loon
- 619 Old Symsonia Rd Ste C
- Benton, KY
- Zip : 42025-5042
- Fax : (270) 527-7882
- Phone : (270) 527-2560
Second Address
- Dr. Glen R. Van Loon
- 619 Old Symsonia Rd Ste C
- Benton, KY
- Zip : 42025-1365
- Fax : (270) 527-7882
- Phone : (270) 527-2560
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 21862 | KY |
National Provider Identifier
| NPI | 1053356675 |
|---|---|
| Provider Name | Dr. Glen R. Van Loon |
| First Address | Benton, KY 42025-5042 |
| Second Address | Benton, KY 42025-1365 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/06/2006 |
| Last Update Date | 01/03/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000049499 | BLUE CROSS ID (01) | KY |
| 64218621 | (05) | KY |
| E66784 | (02) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.