Bouc, Geoffrey Thomas

Bouc, Geoffrey Thomas is an individual health care provider with primary practice located at 3005 Riverside Dr Suite 101, Beloit WI 53511-1500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bouc, Geoffrey Thomas can be contacted via phone (608) 365-7200.

Contact Information

Primary practice address
3005 Riverside Dr Suite 101 Beloit WI 53511-1500
Phone: (608) 365-7200
Fax: (608) 365-7202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36893 Wisconsin

Profile Details

NPI number 1609947159
LBN Legal business name Bouc, Geoffrey Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Jul 8th, 2007 - about 18 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 1609947159 NPPES
Wisconsin MEDICAID 32161500

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