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General NPI Number Information
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NPI Number | 1013477199
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Entity Type | Individual
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Provider Name | LOUGHLIN SOPHIA WYLIE MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2019
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1 BARNES JEWISH HOSPITAL PLZ DIV SURG ACCS
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1003
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Country | US
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Telephone | 314-362-5298
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Fax | 888-824-2176
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Provider Business Mailing Address
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Address Line | PO BOX 7412011
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-362-5298
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Fax | 888-824-2176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 2024031173
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2024031173
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License Number State | MO
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