MEDICARE: JOHN FORREST FLOYD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00019267	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110034752	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	65234	OTHER	WA	LABOR&INDUSTRIES

General Provider Information

NPI Number	:	1114913621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN FORREST FLOYD MD

Provider Business Mailing Address
First Line	:	PO BOX 421
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-0421
Country	:	US
Telephone Number	:	509-624-0111
Fax Number	:	509-227-7070

Provider Business Practice Location Address
First Line	:	546 N JEFFERSON LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-7104
Country	:	US
Telephone Number	:	509-624-0111
Fax Number	:	509-227-7070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	05/18/2021

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Directions to “ JOHN FORREST FLOYD MD” Practice Location

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