Provider Demographics
NPI:1174199905
Name:LOFTON, TIMOTHY LAMAR SR
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LAMAR
Last Name:LOFTON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 RIVERSIDE PKWY NE STE 200
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-2902
Mailing Address - Country:US
Mailing Address - Phone:706-591-5346
Mailing Address - Fax:
Practice Address - Street 1:510 RIVERSIDE PKWY NE STE 200
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-2902
Practice Address - Country:US
Practice Address - Phone:706-591-5346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)