Provider Demographics
NPI:1932171618
Name:LLOYD, DAVID K (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
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 1:1000 AINSWORTH DR STE 115
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1664
Mailing Address - Country:US
Mailing Address - Phone:928-848-9730
Mailing Address - Fax:928-443-8473
Practice Address - Street 1:1000 AINSWORTH DR STE 115
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1667
Practice Address - Country:US
Practice Address - Phone:928-848-9730
Practice Address - Fax:928-443-8473
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2004-07612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10020655OtherLOVELACE HEALTH/SALUD
NM19838735Medicaid
201049623OtherPRESBYTERIAN HEALTH/SALUD
AZ915548Medicaid
QMYPR0068672OtherMOLINA
P00201712OtherRAILROAD MEDICARE
344507101Medicare ID - Type Unspecified
NM19838735Medicaid
Z124136Medicare PIN
10020655OtherLOVELACE HEALTH/SALUD
P00201712OtherRAILROAD MEDICARE