Healthcare Provider Details

I. General information

NPI: 1043278385
Provider Name (Legal Business Name): GREGORY T LYON-LOFTUS PH.D. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6155 ANTHONY HIGHWAY
WAYNESBORO PA
17268-9718
US

IV. Provider business mailing address

785 5TH AVENUE SUITE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-749-3181
  • Fax: 717-749-3191
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-262-4217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD030928E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD030928E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: