Kooistra, Jon B

Kooistra, Jon B is an individual health care provider with primary practice located at 752 N High Point Rd , Madison WI 53717-2236. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Kooistra, Jon B can be contacted via phone (608) 824-4000.

Contact Information

Primary practice address
752 N High Point Rd Madison WI 53717-2236
Phone: (608) 824-4000
Fax: (608) 824-4910
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 18484-020 Wisconsin

Profile Details

NPI number 1649229345
LBN Legal business name Kooistra, Jon B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated May 19th, 2014 - about 10 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 1649229345 NPPES
Wisconsin Other 1175 DEAN HEALTH INSURANCE
Wisconsin MEDICAID 31012500 DEAN HEALTH INSURANCE

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