MEDICARE: DR. LLOYD N HENRY MD, FACS

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	208600000X	Surgery Physician	183	VI

General Provider Information

NPI Number	:	1801882352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LLOYD N HENRY MD, FACS

Provider Business Mailing Address
First Line	:	PO BOX 1126
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00821-1126
Country	:	US
Telephone Number	:	340-778-5450
Fax Number	:	340-778-5450

Provider Business Practice Location Address
First Line	:	4500 SION FARM
Second Line	:	SUITE 1A, ISLAND MEDICAL CENTER
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4493
Country	:	US
Telephone Number	:	340-778-5450
Fax Number	:	340-778-5450

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	12/05/2011

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