Provider Demographics
NPI:1346345923
Name:LOYD, JAMES WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:LOYD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W HESSE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-1501
Mailing Address - Country:US
Mailing Address - Phone:307-684-2449
Mailing Address - Fax:307-684-0241
Practice Address - Street 1:109 W HESSE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834-1501
Practice Address - Country:US
Practice Address - Phone:307-684-2449
Practice Address - Fax:307-684-0241
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYDC560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIDC560OtherWORKERS COMP
WYW306874OtherBLUE CROSS
WYW306874Medicare ID - Type Unspecified
WIDC560OtherWORKERS COMP