Provider Demographics
NPI:1700839222
Name:LOEBELL, JAMES D (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:LOEBELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 BULLARD PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-5512
Mailing Address - Country:US
Mailing Address - Phone:813-985-2811
Mailing Address - Fax:813-985-3045
Practice Address - Street 1:232 BULLARD PKWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-5512
Practice Address - Country:US
Practice Address - Phone:813-985-2811
Practice Address - Fax:813-985-3045
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2556213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390368100Medicaid
FLU27602Medicare UPIN
FL65520Medicare ID - Type Unspecified