Provider Demographics
NPI:1336767714
Name:LOUGHEED, CHRISTY (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:LOUGHEED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:MARIE
Other - Last Name:VANDER GRIENDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSCN
Mailing Address - Street 1:1501 N CAMPBELL AVE RM 6336
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-0001
Mailing Address - Country:US
Mailing Address - Phone:520-626-8818
Mailing Address - Fax:
Practice Address - Street 1:1625 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4330
Practice Address - Country:US
Practice Address - Phone:520-626-1232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-11
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR78111207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine