Provider Demographics
NPI:1952516825
Name:LOY, DAVID NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NEIL
Last Name:LOY
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:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-7200
Mailing Address - Fax:314-747-4189
Practice Address - Street 1:510 S KINGSHIGHWAY BLVD
Practice Address - Street 2:DEPT RADIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1016
Practice Address - Country:US
Practice Address - Phone:314-362-7200
Practice Address - Fax:314-747-4189
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070122962085N0700X, 2085R0202X, 2085R0202X
CODR.00497952085R0202X
VA01012630962085R0202X
NE261582085R0202X
CO497952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200866360AMedicaid
CO48852287Medicaid
MT1952516825Medicaid
WY1952516825Medicaid
WY1952516825Medicaid
COCOAAA1544Medicare PIN
COCOAAA1545Medicare PIN
KS200866360AMedicaid
NENA1214067Medicare PIN
CO394473ZLJ3Medicare PIN
COP01021554Medicare PIN
COCOAAA2060Medicare PIN
NENA1215067Medicare PIN
CO48852287Medicaid
MT1952516825Medicaid
NENA2517053Medicare PIN