Provider Demographics
NPI:1164523494
Name:LLOYD, CAREY DEYOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:DEYOUNG
Last Name:LLOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12173
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84412-2173
Mailing Address - Country:US
Mailing Address - Phone:435-734-2433
Mailing Address - Fax:435-734-0059
Practice Address - Street 1:980 MEDICAL DR
Practice Address - Street 2:#2
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3094
Practice Address - Country:US
Practice Address - Phone:435-734-2433
Practice Address - Fax:435-734-0059
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT313975-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
870631360OtherALTIUS
107007623101OtherSELECTHEALTH
870631360OtherALTIUS