Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | WI |
NPI | 1003873217 |
---|---|
Provider Name | Gregory R Lochen |
First Address | Waukesha, WI 53188-3417 |
Second Address | Waukesha, WI 53188-3417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 18/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0800072 | UNITED HEALTHCARE (01) | WI |
103431 | HEALTH ALLIANCE (01) | WI |
30125200 | (05) | WI |
30125200 | ABRI (01) | WI |
30125200 | MANAGED HEALTH SERVICES (01) | WI |
4016335 | AETNA (01) | WI |
747042 | MOHAWK (01) | WI |
822601 | VIPA (01) | WI |
B54639 | (02) | WI |