Healthcare Provider Details

I. General information

NPI: 1275508640
Provider Name (Legal Business Name): JOHN C LLOYD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 CANTERBURY DR SUITE 210
HAYS KS
67601-2375
US

IV. Provider business mailing address

2214 CANTERBURY DR SUITE 210
HAYS KS
67601-2375
US

V. Phone/Fax

Practice location:
  • Phone: 785-623-5806
  • Fax: 785-623-2343
Mailing address:
  • Phone: 785-623-5806
  • Fax: 785-623-2343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number04-21581
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: