Provider Demographics
NPI:1720070790
Name:LOFFER, FRANKLIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:D
Last Name:LOFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3905
Mailing Address - Country:US
Mailing Address - Phone:602-241-1944
Mailing Address - Fax:602-241-1917
Practice Address - Street 1:3410 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3905
Practice Address - Country:US
Practice Address - Phone:602-241-1944
Practice Address - Fax:602-241-1917
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4822207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ208266Medicaid
AZ4022253OtherAETNA
AZAZ0027690OtherBLUE CROSS BLUE SHIELD
AZ160039851OtherRAILROAD MEDICARE
AZAZ0027690OtherBLUE CROSS BLUE SHIELD
AZZ$$$$$$$$$Medicare PIN