Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35129984 | OH |
NPI | 1093014300 |
---|---|
Provider Name | Michael J Loochtan |
First Address | Columbus, OH 43220-2967 |
Second Address | Columbus, OH 43214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2011 |
Last Update Date | 30/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0213509 | (05) | OH |