Healthcare Provider Details
I. General information
NPI: 1982927166
Provider Name (Legal Business Name): CORTLAND JESSE LOHFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/02/2010
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PO BOX 26110
SANTA FE NM
87502-0110
US
IV. Provider business mailing address
PO BOX 26110
SANTA FE NM
87502-0110
US
V. Phone/Fax
- Phone: 312-515-4409
- Fax:
- Phone: 312-515-4409
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | MD2024-0959 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: