Provider Demographics
NPI:1609844489
Name:LOUTHAN, FRANK BLONVIL III (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:BLONVIL
Last Name:LOUTHAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 MEDICAL CENTER PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2586
Mailing Address - Country:US
Mailing Address - Phone:615-849-9868
Mailing Address - Fax:615-898-1882
Practice Address - Street 1:1800 MEDICAL CENTER PKWY STE 310
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2586
Practice Address - Country:US
Practice Address - Phone:615-849-9868
Practice Address - Fax:615-898-1882
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD20149207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3081176Medicaid
TN3044166OtherBLUE CROSS
TN3081176Medicaid
TN3081176Medicare ID - Type Unspecified