Provider Demographics
NPI:1558503680
Name:JAVIER, LLOYD SIJERA (MD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:SIJERA
Last Name:JAVIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-935-8581
Mailing Address - Fax:765-935-1171
Practice Address - Street 1:1471 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1945
Practice Address - Country:US
Practice Address - Phone:765-935-8581
Practice Address - Fax:765-935-1171
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070681A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0070507Medicaid
IN201076610Medicaid
000000775560OtherANTHEM
IN201076610Medicaid