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NPI Code Detail

MEDICARE: DR. MICHAEL TIMOTHY LOUGHLIN D.O.

MEDICARE: DR. MICHAEL TIMOTHY LOUGHLIN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician34.013224OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003043647
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL TIMOTHY LOUGHLIN D.O.
Provider Business Mailing Address
First Line : ONE GI CREDENTIALING DEPARTMENT
Second Line : PO BOX 381468
City : GERMANTOWN
State : TN
Zip : 38183-3237
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 75 SYLVANIA DR
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45440
Country : US
Telephone Number : 937-320-5050
Fax Number : 937-320-5060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2009
Last Update Date : 02/09/2026

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