Healthcare Provider Details

I. General information

NPI: 1104818418
Provider Name (Legal Business Name): PAMLICO PODIATRY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W 15TH ST
WASHINGTON NC
27889-3524
US

IV. Provider business mailing address

403 W 15TH ST
WASHINGTON NC
27889-3524
US

V. Phone/Fax

Practice location:
  • Phone: 252-946-0324
  • Fax: 252-948-0558
Mailing address:
  • Phone: 252-946-0324
  • Fax: 252-948-0558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LAURA ANN LLOYD
Title or Position: OWNER/PODIATRIST
Credential: DPM
Phone: 252-946-0324