Provider Demographics
NPI:1154311330
Name:LOOFF, JOHN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:LOOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1720 NICHOLASVILLE RD
Mailing Address - Street 2:STE 411
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1404
Mailing Address - Country:US
Mailing Address - Phone:859-278-0363
Mailing Address - Fax:859-278-5317
Practice Address - Street 1:1720 NICHOLASVILLE RD
Practice Address - Street 2:STE 411
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1404
Practice Address - Country:US
Practice Address - Phone:859-278-0363
Practice Address - Fax:859-278-5317
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY21424207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64214240Medicaid
KY325022Medicare PIN
C75152Medicare UPIN