MEDICARE: DR. THOMAS MARION LOEB 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
1	207X00000X	Orthopaedic Surgery Physician	16798	KY
2	174400000X	Specialist	16798	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1299470001	OTHER	KY	PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336142447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS MARION LOEB M.D.

Provider Business Mailing Address
First Line	:	100 E LIBERTY ST
Second Line	:	SUITE 800
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1434
Country	:	US
Telephone Number	:	502-253-4120
Fax Number	:	502-253-4121

Provider Business Practice Location Address
First Line	:	3920 DUTCHMANS LN
Second Line	:	SUITE 310
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4702
Country	:	US
Telephone Number	:	502-253-4120
Fax Number	:	502-253-4121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/07/2016

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