Healthcare Provider Details

I. General information

NPI: 1992000509
Provider Name (Legal Business Name): SEAN LLOYD PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

791 CHAMBERS RD
AURORA CO
80011-7112
US

IV. Provider business mailing address

3701 S BROADWAY
ENGLEWOOD CO
80113-3611
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-6276
  • Fax: 303-343-3877
Mailing address:
  • Phone: 303-360-6276
  • Fax: 303-467-5355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6014
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA.0003944
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: