| Doctor Name: | MR. DAVID MICHAEL LOFSTROM |
| NPI Number: | 1053384495 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | A.P.R.N. |
| License Number: | RN073531 |
| Business Practice Address: | 707 South Vienna Ruston, LA - 712705845 |
| Business Phone Number: | 3182518001 |
| Business Fax Number: | 3186998845 |
| Mailing Address: | 1809 Northpointe Lane, Suite 203 RUSTON |
| State: | LA |
| Postal Code: | 712703852 |
| Phone Number: | 3182518001 |
| Fax Number: | 3186998843 |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 08/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | RN073531 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |