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General NPI Number Information
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NPI Number | 1164657680
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Entity Type | Organization
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Legal Business Name | LLOYD PODIATRY GROUP INC
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 13914 STATE ROAD 238 E
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City | FISHERS
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State | IN
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Zip | 46037-5506
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Country | US
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Telephone | 317-842-1381
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Fax |
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Provider Business Mailing Address
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Address Line | 13914 STATE ROAD 238 E
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City | FISHERS
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State | IN
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Zip | 46037-5506
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Country | US
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Telephone | 317-842-1381
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | LISA LOHREY
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Credential |
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Telephone | 317-336-2106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000551A
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License Number State | IN
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