Provider Demographics
NPI:1275514028
Name:FLOYD, ROBERT DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DANIEL
Last Name:FLOYD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N MADISON ST.
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52537-1271
Mailing Address - Country:US
Mailing Address - Phone:641-664-3832
Mailing Address - Fax:641-664-1857
Practice Address - Street 1:509 N MADISON ST.
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IA
Practice Address - Zip Code:52537-1271
Practice Address - Country:US
Practice Address - Phone:641-664-3832
Practice Address - Fax:641-664-1857
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3537207R00000X
MO113318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1275514028Medicaid
MO245114400Medicaid
IA125514028Medicaid
IAI20329Medicare PIN
311555384Medicare PIN
MO311555384Medicare PIN
MO245114400Medicaid
H12930Medicare UPIN