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General NPI Number Information
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NPI Number | 1760564058
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Entity Type | Organization
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Legal Business Name | LOFGREEN FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1257 W WARNER RD SUITE A-4
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City | CHANDLER
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State | AZ
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Zip | 85224-2713
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Country | US
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Telephone | 480-777-9333
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Fax | 480-838-9666
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Provider Business Mailing Address
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Address Line | 1257 W WARNER RD SUITE A-4
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City | CHANDLER
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State | AZ
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Zip | 85224-2713
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Country | US
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Telephone | 480-777-9333
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Fax | 480-838-9666
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JOHN M LOFGREEN
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Credential | M.D.
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Telephone | 480-688-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13455
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License Number State | AZ
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