Individual
MR. DAVID MICHAEL LOFSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N.
Contact information
Practice address
707 SOUTH VIENNA, RUSTON, LA 71270-5845
(318) 251-8001
(318) 699-8845
Mailing address
1809 NORTHPOINTE LANE, SUITE 203, RUSTON, LA 71270-3852
(318) 251-8001
(318) 699-8843
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
RN073531
LA
363AS0400X
Surgical Physician Assistant
RN073531
LA
363LF0000X
Family Nurse Practitioner
Primary
RN073531-AP03121
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1698318
—
LA
Enumeration date
02/08/2006
Last updated
08/08/2012
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