Provider Demographics
NPI:1164678520
Name:ESTES, LLOYD WAYNE (PEDORTHIST)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:WAYNE
Last Name:ESTES
Suffix:
Gender:M
Credentials:PEDORTHIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 WETUPKA WAY
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-4420
Mailing Address - Country:US
Mailing Address - Phone:662-560-7137
Mailing Address - Fax:662-449-4394
Practice Address - Street 1:11301 WETUPKA WAY
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-4420
Practice Address - Country:US
Practice Address - Phone:662-560-7137
Practice Address - Fax:662-449-4394
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-16
Last Update Date:2008-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist