MEDICARE: ASHLEY LYNN LOUGHNER 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
1	207Q00000X	Family Medicine Physician	OS020329	PA

General Provider Information

NPI Number	:	1417343831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LYNN LOUGHNER D.O.

Provider Business Mailing Address
First Line	:	1500 VILLAGE RUN RD STE 308
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-6316
Country	:	US
Telephone Number	:	724-934-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 VILLAGE RUN RD STE 308
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-6316
Country	:	US
Telephone Number	:	724-934-1900
Fax Number	:

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

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	03/02/2024

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