Provider Demographics
NPI:1013339373
Name:LLOYD, KAYDON J (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYDON
Middle Name:J
Last Name:LLOYD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYDON
Other - Middle Name:
Other - Last Name:LLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3916 STATE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5602
Mailing Address - Country:US
Mailing Address - Phone:800-230-5160
Mailing Address - Fax:801-682-1458
Practice Address - Street 1:1200 E 3900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1300
Practice Address - Country:US
Practice Address - Phone:801-268-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2013-0095363AS0400X
AZ5771363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ953680Medicaid
AZ953680Medicaid