Komp, Thomas R

Komp, Thomas R is an individual health care provider with primary practice located at 1800 Lawrence Dr , De Pere WI 54115-9108. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Komp, Thomas R can be contacted via phone (920) 983-3220.

Contact Information

Primary practice address
1800 Lawrence Dr De Pere WI 54115-9108
Phone: (920) 983-3220
Fax: (920) 983-3226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 534-025 Wisconsin

Profile Details

NPI number 1265424162
LBN Legal business name Komp, Thomas R
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated May 17th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265424162 NPPES
Wisconsin Other 41732500 MEDICAID DME
Wisconsin MEDICAID 43205900 MEDICAID DME
Wisconsin Other 0256660001 MEDICAID DME

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