Healthcare Provider Details

I. General information

NPI: 1083875850
Provider Name (Legal Business Name): BRIDGET CATHERINE LOEHN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 WOLF CIR
LAKE CHARLES LA
70605-2348
US

IV. Provider business mailing address

1615 WOLF CIR
LAKE CHARLES LA
70605-2348
US

V. Phone/Fax

Practice location:
  • Phone: 337-419-1960
  • Fax: 337-419-1961
Mailing address:
  • Phone: 337-312-8258
  • Fax: 337-312-6708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD.202932
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: