=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003806019
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENNIS M LLOYD DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2005
-----------------------------------------------------
Last Update Date | 09/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1119 VILLA LINDE CT STE 37
-----------------------------------------------------
City | FLINT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48532-3410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-241-6952
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2036 N SEYMOUR RD
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48433-9733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-241-6952
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 5101007566
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------