Individual
MR. TIMOTHY J LOERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13151 MAGISTERIAL DR STE 200, LOUISVILLE, KY 40223-4103
(502) 587-1236
(502) 587-0126
Mailing address
200 MISSOURI AVE, JEFFERSONVILLE, IN 47130-3061
(865) 293-5335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10002494A
IN
363A00000X
Physician Assistant
Primary
PA1785
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098783
NCCPA
TX
05
—
288231801
—
TX
01
—
PA07315
TEXAS STATE LICENSE
TX
01
—
PA1785
KENTUCKY STATE LICENSE
KY
Enumeration date
08/23/2011
Last updated
06/20/2024
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