Provider Demographics
NPI:1790044816
Name:LLOYD, ISAAC ERICSON (MD)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:ERICSON
Last Name:LLOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 CIRCLE OF HOPE DR RM N3105
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112-5500
Mailing Address - Country:US
Mailing Address - Phone:801-587-4281
Mailing Address - Fax:801-585-2805
Practice Address - Street 1:1950 CIRCLE OF HOPE DR RM N3105
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5500
Practice Address - Country:US
Practice Address - Phone:801-587-4281
Practice Address - Fax:801-585-2805
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8831892-1205207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty