Provider Demographics
NPI:1376505255
Name:LOO, FRANKLIN D (MD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:D
Last Name:LOO
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 1:3003 W GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2042
Mailing Address - Country:US
Mailing Address - Phone:414-352-3100
Mailing Address - Fax:
Practice Address - Street 1:2901 W KK RIVER PKWY
Practice Address - Street 2:SUITE 414
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3677
Practice Address - Country:US
Practice Address - Phone:414-649-3750
Practice Address - Fax:414-649-3411
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20620207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00705314OtherRR MEDICARE
WI30386500Medicaid
WI01994-0341Medicare PIN
WI46236-4631Medicare PIN
B54668Medicare UPIN