Provider Demographics
NPI:1255584223
Name:LOEFFLER, HUGH HARRISON (MD)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:HARRISON
Last Name:LOEFFLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HUGH
Other - Middle Name:HARRISON
Other - Last Name:LOEFFLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 910670
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0670
Mailing Address - Country:US
Mailing Address - Phone:859-971-4685
Mailing Address - Fax:859-971-4602
Practice Address - Street 1:1138 LEXINGTON RD STE 290
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9672
Practice Address - Country:US
Practice Address - Phone:502-863-0721
Practice Address - Fax:502-863-6104
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44636207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100126050Medicaid
KYK011122Medicare PIN