Provider Demographics
NPI:1164670568
Name:LLOYD J STORY MD, PA
Entity Type:Organization
Organization Name:LLOYD J STORY MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:J
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-768-4460
Mailing Address - Street 1:755 HIGHLAND OAKS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7106
Mailing Address - Country:US
Mailing Address - Phone:336-768-4460
Mailing Address - Fax:336-659-8759
Practice Address - Street 1:755 HIGHLAND OAKS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7106
Practice Address - Country:US
Practice Address - Phone:336-768-4460
Practice Address - Fax:336-659-8759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14860207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty