Provider Demographics
NPI:1265031520
Name:LOEFFLER, ABIGAIL MACKENZIE (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MACKENZIE
Last Name:LOEFFLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-7171
Mailing Address - Fax:614-366-0003
Practice Address - Street 1:2050 KENNY RD FL 8
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-7171
Practice Address - Fax:614-366-0003
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006728RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant