Provider Demographics
NPI:1760498554
Name:LOEBL, EDWARD C (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:LOEBL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6236 N SABINO SHADOW LN
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-3800
Mailing Address - Country:US
Mailing Address - Phone:520-615-5254
Mailing Address - Fax:
Practice Address - Street 1:9601 LILE DRIVE
Practice Address - Street 2:SUITE 250
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-227-4787
Practice Address - Fax:501-202-1465
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ367972086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104827001Medicaid
ARB90393Medicare UPIN
AR53187Medicare ID - Type Unspecified