Healthcare Provider Details

I. General information

NPI: 1255584223
Provider Name (Legal Business Name): HUGH HARRISON LOEFFLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HUGH HARRISON LOEFFLER MD

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 06/26/2021
Certification Date: 06/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 LEXINGTON RD STE 290
GEORGETOWN KY
40324-9672
US

IV. Provider business mailing address

PO BOX 910670
LEXINGTON KY
40591-0670
US

V. Phone/Fax

Practice location:
  • Phone: 502-863-0721
  • Fax: 502-863-6104
Mailing address:
  • Phone: 859-971-4685
  • Fax: 859-971-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number44636
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number44636
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: