Provider Demographics
NPI:1982675211
Name:LOKER, RONALD L (PA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:LOKER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3503 SAMSON WAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4303
Mailing Address - Country:US
Mailing Address - Phone:402-592-2055
Mailing Address - Fax:402-592-2419
Practice Address - Street 1:3503 SAMSON WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4303
Practice Address - Country:US
Practice Address - Phone:402-592-2055
Practice Address - Fax:402-592-2419
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE395363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NES69227Medicare UPIN
NE271250Medicare ID - Type Unspecified