Provider Demographics
NPI:1114149010
Name:LOEFFLER, LAUREN F (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:F
Last Name:LOEFFLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 E THOMAS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-0008
Mailing Address - Country:US
Mailing Address - Phone:602-933-3124
Mailing Address - Fax:
Practice Address - Street 1:1920 E CAMBRIDGE AVE STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1462
Practice Address - Country:US
Practice Address - Phone:602-933-0965
Practice Address - Fax:602-933-4610
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ718002080P0210X
VA0116018592390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology