Provider Demographics
NPI:1255321303
Name:BARDWELL, LLOYD RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:RICHARD
Last Name:BARDWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:699 CHURCH ST NE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1110
Mailing Address - Country:US
Mailing Address - Phone:770-793-9750
Mailing Address - Fax:770-919-0581
Practice Address - Street 1:699 CHURCH ST NE
Practice Address - Street 2:SUITE 500
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1110
Practice Address - Country:US
Practice Address - Phone:770-793-9750
Practice Address - Fax:770-919-0581
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA027960207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology