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NPI Code Detail

MEDICARE: WILLIAM BRADLEY LOFTON M.D.

MEDICARE: WILLIAM BRADLEY LOFTON M.D.
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
1207R00000XInternal Medicine PhysicianMD35119TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114927969
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM BRADLEY LOFTON M.D.
Provider Business Mailing Address
First Line : 1030 JEFFERSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-2127
Country : US
Telephone Number : 901-523-8990
Fax Number :
Provider Business Practice Location Address
First Line : 1030 JEFFERSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-2127
Country : US
Telephone Number : 15-238-9909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 05/13/2024

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