Provider Demographics
NPI:1306860507
Name:LOEWEN, JONATHAN J (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:J
Last Name:LOEWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1106
Mailing Address - Country:US
Mailing Address - Phone:620-662-6000
Mailing Address - Fax:620-669-2394
Practice Address - Street 1:1818 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1106
Practice Address - Country:US
Practice Address - Phone:620-662-6000
Practice Address - Fax:620-669-2394
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0425445207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100576OtherBLUE CROSS PROVIDER NO.
KS100576OtherBLUE CROSS PROVIDER NO.
KSG85966Medicare UPIN