Thomas B. Huizenga, M.D.,S.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

49399 Issued in WI

Legal business name

THOMAS B. HUIZENGA, M.D.,S.C.

Practice address

525 W River Woods Pkwy Ste 130
Glendale, WI 53212-1010

Phone

(414) 961-0304

Fax

(414) 961-2061

NPI assigned

Nov 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlene D Bost

Title

Office Manager

Phone

(414) 961-0304

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1497935290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N MAYFAIR RD STE 500",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261415",
            "telephone_number": "414-257-2525",
            "fax_number": "414-961-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W RIVER WOODS PKWY STE 130",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121010",
            "telephone_number": "414-961-0304",
            "fax_number": "414-961-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS B. HUIZENGA, M.D.,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "BOST",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "414-961-0304"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "49399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34874500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mary Rudolph Thomas, PT
• Zachary Lee Thomason, OD
• Darcy L Thompson, LCSW, CSW, MSW
• Sydney Thorson, OTR/L
• Elizabeth Anne Threasher, PT, DPT, WCC

• Orthopaedic Surgery Physician in Glendale, WI
• Providers in Glendale, WI by specialty
• Orthopaedic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.