Individual
ERIC LOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 JACARANDA BLVD UNIT 2, VENICE, FL 34292-4520
(941) 483-3377
(941) 483-4687
Mailing address
PO BOX 25487, SARASOTA, FL 34277-2487
(941) 483-3377
(941) 483-4687
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME79796
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35473
BLUE SHIELD
FL
Enumeration date
09/15/2006
Last updated
12/29/2020
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