Provider Demographics
NPI:1922620566
Name:FLOYD, BILLY W
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:W
Last Name:FLOYD
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 1:2926 LEE ELLEN PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3721
Mailing Address - Country:US
Mailing Address - Phone:614-216-2869
Mailing Address - Fax:
Practice Address - Street 1:7400 HUNTINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5617
Practice Address - Country:US
Practice Address - Phone:614-505-0378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-16
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH099197164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse