Provider Demographics
NPI:1275728891
Name:LOYD, GAYLE S (RD LDN)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:S
Last Name:LOYD
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 HADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-2444
Mailing Address - Country:US
Mailing Address - Phone:618-656-8928
Mailing Address - Fax:618-288-3638
Practice Address - Street 1:6800 STATE RT 162
Practice Address - Street 2:ANDERSON HOSPITAL
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-8500
Practice Address - Country:US
Practice Address - Phone:618-391-5241
Practice Address - Fax:618-288-3638
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP73024Medicare UPIN
IL203398Medicare PIN