Healthcare Provider Details

I. General information

NPI: 1427686732
Provider Name (Legal Business Name): LLOYD DALTON BORDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3448 US ROUTE 60
HUNTINGTON WV
25705-2906
US

IV. Provider business mailing address

3448 US ROUTE 60
HUNTINGTON WV
25705-2906
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-1550
  • Fax: 304-522-1073
Mailing address:
  • Phone: 304-522-1550
  • Fax: 304-522-1073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number36196
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number36196
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: