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Individual

MICHAEL CANNON LOFTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
750 OLD HICKORY BLVD, BLDG #2, SUITE 150, BRENTWOOD, TN 37027-4528
(615) 371-6188
(615) 595-2865
Mailing address
1230 LIMERICK LN, FRANKLIN, TN 37067-8514
(615) 371-6188
(615) 595-2865

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000002412
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3585304
TN
01
4047159
BCBS OF TENNESSEE
TN
01
4133923
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
06/08/2006
Last updated
07/08/2007
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