Provider Demographics
NPI:1174897631
Name:LOFTON, ALFRED
Entity type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:
Last Name:LOFTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 GREENWELL SPRINGS RD APT 21
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-2205
Mailing Address - Country:US
Mailing Address - Phone:225-368-7527
Mailing Address - Fax:225-448-2992
Practice Address - Street 1:8235 GREENWELL SPRINGS RD APT 21
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-2205
Practice Address - Country:US
Practice Address - Phone:225-368-7527
Practice Address - Fax:225-448-2992
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008107744343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)