Provider Demographics
NPI:1689624744
Name:LOOMIS, KARL FRENCH (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:FRENCH
Last Name:LOOMIS
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 1:603 N KALAMAZOO AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1076
Mailing Address - Country:US
Mailing Address - Phone:269-781-4560
Mailing Address - Fax:269-781-3659
Practice Address - Street 1:603 N KALAMAZOO AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1076
Practice Address - Country:US
Practice Address - Phone:269-781-4560
Practice Address - Fax:269-781-3659
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045613207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1846053Medicaid
MIOB3706001Medicare ID - Type Unspecified
MI1846053Medicaid