MEDICARE: DR. PHILIP L LOYD D.C.

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	111N00000X	Chiropractor	006049	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	352220932	OTHER	MO	TAX ID

General Provider Information

NPI Number	:	1538223201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP L LOYD D.C.

Provider Business Mailing Address
First Line	:	607 W BATTLEFIELD ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-4123
Country	:	US
Telephone Number	:	417-869-2000
Fax Number	:	417-889-4755

Provider Business Practice Location Address
First Line	:	607 W BATTLEFIELD ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-4123
Country	:	US
Telephone Number	:	417-869-2000
Fax Number	:	417-889-4755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	10/14/2008

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