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1932132917
GRANT KEITH LOFTON
JACKSON, MS
NPI
1932132917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: MS R587052)
Enumeration Date
2006-07-10
Last Update Date
2007-07-08
Business Address
-- GRANT KEITH LOFTON CFNP
1500 E WOODROW WILSON AVE
JACKSON, MS 39216-5116
Phone number: 601-362-4471
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Mailing Address
-- GRANT KEITH LOFTON CFNP
709 CHARLIE DIXON RD
BRAXTON, MS 39044-9315
Phone number: 601-362-4471
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