Provider Demographics
NPI:1578670816
Name:LOUGHLIN, STEPHEN F (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:LOUGHLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WINTER STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTHBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01745
Mailing Address - Country:US
Mailing Address - Phone:508-481-6351
Mailing Address - Fax:508-481-0261
Practice Address - Street 1:16 WINTER STREET
Practice Address - Street 2:
Practice Address - City:SOUTHBORO
Practice Address - State:MA
Practice Address - Zip Code:01745
Practice Address - Country:US
Practice Address - Phone:508-481-6351
Practice Address - Fax:508-481-0261
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9786805Medicaid
MAP1115700OtherMULTIPLAN
MAY39225OtherBCBS
MA779635OtherTUFTS
MA111147OtherAETRIA
MA351007OtherHPHC
MAY35450Medicare PIN
MAP1115700OtherMULTIPLAN