Provider Demographics
NPI:1285725820
Name:LOOYSEN, STEVE W (OD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:W
Last Name:LOOYSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:210 10TH ST SE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-5553
Mailing Address - Country:US
Mailing Address - Phone:701-252-5000
Mailing Address - Fax:701-952-5005
Practice Address - Street 1:821 1ST AVE S
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4746
Practice Address - Country:US
Practice Address - Phone:701-252-3937
Practice Address - Fax:701-952-3937
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ND413152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND60357Medicaid
ND21942OtherBCBS OF ND
ND60357Medicaid