Provider Demographics
NPI:1760485882
Name:LOFTUS, TODD C (DPM)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:C
Last Name:LOFTUS
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 1:4260 GLENDALE MILFORD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3763
Mailing Address - Country:US
Mailing Address - Phone:513-769-4408
Mailing Address - Fax:513-769-4578
Practice Address - Street 1:4260 GLENDALE MILFORD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-3763
Practice Address - Country:US
Practice Address - Phone:513-769-4408
Practice Address - Fax:513-769-4578
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003243213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2456739Medicaid
OHP00079138OtherRAILROAD MEDICARE
OH2054351Medicaid
OHCL1653OtherRAILROAD MEDICARE
OH4112142Medicare PIN
OH4112144Medicare PIN
OHCL1653OtherRAILROAD MEDICARE