Provider Demographics
NPI:1467457200
Name:RETTIG, LLOYD WILLIAM III (MD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:WILLIAM
Last Name:RETTIG
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9000 N MAIN ST
Mailing Address - Street 2:SUITE 232
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1180
Mailing Address - Country:US
Mailing Address - Phone:937-277-8988
Mailing Address - Fax:937-832-2421
Practice Address - Street 1:9000 N MAIN ST
Practice Address - Street 2:SUITE 232
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1180
Practice Address - Country:US
Practice Address - Phone:937-277-8988
Practice Address - Fax:937-832-2421
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.065432207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0253425Medicaid
OH0253425Medicaid
OHH436360Medicare PIN