Provider Demographics
NPI:1134209174
Name:LLOYD, LISA B
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:LLOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 W GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2042
Mailing Address - Country:US
Mailing Address - Phone:414-352-3100
Mailing Address - Fax:414-247-4597
Practice Address - Street 1:8905 W LINCOLN AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2468
Practice Address - Country:US
Practice Address - Phone:414-978-2229
Practice Address - Fax:414-978-2279
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27473207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00705311OtherRR MEDICARE
WI30726100Medicaid
WI30726100Medicaid
WIP00705311OtherRR MEDICARE
WIE47579Medicare UPIN