Provider Demographics
NPI:1255350781
Name:LOFTIN, NELL ELAINE (MD)
Entity type:Individual
Prefix:
First Name:NELL
Middle Name:ELAINE
Last Name:LOFTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 K ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3331
Mailing Address - Country:US
Mailing Address - Phone:907-272-2571
Mailing Address - Fax:
Practice Address - Street 1:718 K ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3331
Practice Address - Country:US
Practice Address - Phone:907-272-2571
Practice Address - Fax:907-272-6751
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA1991207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1991Medicaid
AKMD1991Medicaid
AKK011WCGXWDMedicare PIN