Provider Demographics
NPI:1326134958
Name:JONES, LLOYD EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:EDWARD
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 ULULANI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4433
Mailing Address - Country:US
Mailing Address - Phone:808-261-7776
Mailing Address - Fax:808-261-7776
Practice Address - Street 1:747 ULULANI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4433
Practice Address - Country:US
Practice Address - Phone:808-261-7776
Practice Address - Fax:808-261-7776
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 3047174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000041624OtherHMSA
HI037883 01Medicaid
HI99020222196734A002OtherTRICARE
HIMD 3047OtherOTHER -- LICENSE #
HID36344Medicare UPIN
HIH0000BDGRVMedicare ID - Type Unspecified