Provider Demographics
NPI:1366624660
Name:COON, LLOYD C
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:C
Last Name:COON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 CHENIERE DREW RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8539
Mailing Address - Country:US
Mailing Address - Phone:318-396-2319
Mailing Address - Fax:318-397-9697
Practice Address - Street 1:529 CHENIERE DREW RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8539
Practice Address - Country:US
Practice Address - Phone:318-396-2319
Practice Address - Fax:318-397-9697
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1287810001Medicare NSC