Provider Demographics
NPI:1932131935
Name:TRICHELL, LLOYD (DPM)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:
Last Name:TRICHELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-1705
Mailing Address - Country:US
Mailing Address - Phone:479-587-0171
Mailing Address - Fax:479-587-0885
Practice Address - Street 1:509 E MILLSAP RD
Practice Address - Street 2:SUITE #101
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4067
Practice Address - Country:US
Practice Address - Phone:479-587-0171
Practice Address - Fax:479-587-0885
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR116213E00000X
OK172213E00000X
TX0902213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5843039OtherAETNA
AR15934000000OtherQUALCHOICE OF ARKANSAS
AR56240OtherCHAMPUS
AR56240OtherBC/BS
AR119165717Medicaid
2720061OtherUNITED HEALTHCARE
AR148124748Medicaid
AR387675OtherHEALTHLINK
AR5843039OtherAETNA
AR119165717Medicaid
AR56240Medicare PIN