MEDICARE: LOYDPIERSON, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C001636	NC

General Provider Information

NPI Number	:	1154561967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOYDPIERSON, INC.

Provider Business Mailing Address
First Line	:	3214 STONEYBROOK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-3154
Country	:	US
Telephone Number	:	704-342-3456
Fax Number	:

Provider Business Practice Location Address
First Line	:	3214 STONEYBROOK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-3154
Country	:	US
Telephone Number	:	704-342-3456
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PHILIP LOYDPIERSON
Credential	:	M.S.W.
Telephone Number	:	704-342-3456

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	03/06/2009

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