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Organization

W.ERIC LOCH,M.D.,P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER ERIC LOCH M.D. (PRESIDENT)
(386) 719-9993
Entity
Organization

Contact information

Practice address
4551 W US HIGHWAY 90, SUITE 101, LAKE CITY, FL 32055-8836
(386) 719-9993
(386) 719-4744
Mailing address
4551 W US HIGHWAY 90, SUITE101, LAKE CITY, FL 32055-8835
(386) 719-9993
(386) 719-4744

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME102204
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52026
BLUE CROSS AND BLUE SHIELD
FL
Enumeration date
11/05/2009
Last updated
11/05/2009
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