Provider Demographics
NPI:1174603138
Name:LOECHNER, KAREN (MD, PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LOECHNER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 TULLIE RD NE FL 3
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2309
Mailing Address - Country:US
Mailing Address - Phone:404-785-5437
Mailing Address - Fax:404-785-9111
Practice Address - Street 1:505 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1901
Practice Address - Country:US
Practice Address - Phone:860-837-6700
Practice Address - Fax:860-837-6765
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA754652080P0205X
NH149522080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89130TRMedicaid
NHA2355401Medicare PIN
NC89130TRMedicaid
NC2298166Medicare PIN