Individual
DR. JEAN-CLAUDE LOISEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1264 WESLEY DR, STE 304, MEMPHIS, TN 38116-6400
(901) 398-1990
(901) 398-1996
Mailing address
1264 WESLEY DR, STE 304, MEMPHIS, TN 38116-6400
(901) 398-1990
(901) 398-1996
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
17160
MS
208600000X
Surgery Physician
Primary
30033
TN
208600000X
Surgery Physician
35045444L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122348
—
MS
01
—
0482986007
CIGNA ID #
—
01
—
3088094
BC BS #
TN
01
—
4280919
AETNA ID #
TN
05
—
9015315
—
MS
Enumeration date
08/09/2005
Last updated
10/14/2011
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