Glen R. Van Loon MD PH.D.

NPI 1053356675 - Internal Medicine - 207RE0101X

NPI Details
NPI 1053356675
Gender Male
Enumeration Date 06/18/2006
Last Updated 03/01/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
619 OLD SYMSONIA RD
STE C
BENTON KY, 42025-1365, US
Phone (270) 527-2560
Fax (270) 527-7882
Business Location
619 OLD SYMSONIA RD
STE C
BENTON KY, 42025-5042, US
Phone (270) 527-2560
Fax (270) 527-7882
Toxanomy
Taxonomy Code 207RE0101X
License State Kentucky
License Number 21862
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According to our database, Dr. Glen R. Van Loon MD PH.D. NPI is 1053356675, taxonomy code is 207RE0101X and license number is 21862, license state is located at Kentucky. Glen R. Van Loon MD PH.D. physically located at 619 Old Symsonia Rd, Benton KY, 42025-1365. NPI Number Glen R. Van Loon MD PH.D. has the Individual type.

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1053356675 NPI number is provided on an as is basis without warranty of any kind. 1053356675 is maintained by the National Plan & Provider Enumeration System. The contents of Glen R. Van Loon MD PH.D. are for informational purposes only.