Provider Demographics
NPI:1316144306
Name:LOFTON FAMILY CLINIC, MD PA
Entity type:Organization
Organization Name:LOFTON FAMILY CLINIC, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOFTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-642-4000
Mailing Address - Street 1:203 W DEQUEEN AVE
Mailing Address - Street 2:
Mailing Address - City:DE QUEEN
Mailing Address - State:AR
Mailing Address - Zip Code:71832-2809
Mailing Address - Country:US
Mailing Address - Phone:870-642-4000
Mailing Address - Fax:870-642-8708
Practice Address - Street 1:203 W DEQUEEN AVE
Practice Address - Street 2:
Practice Address - City:DE QUEEN
Practice Address - State:AR
Practice Address - Zip Code:71832-2809
Practice Address - Country:US
Practice Address - Phone:870-642-4000
Practice Address - Fax:870-277-4293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE 4640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty