MEDICARE: ANDREW LLOYD DELO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1376435560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW LLOYD DELO

Provider Business Mailing Address
First Line	:	1401 CRYSTAL
Second Line	:
City	:	BENTON
State	:	AR
Zip	:	72015-3013
Country	:	US
Telephone Number	:	318-465-4388
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	318-846-5438
Fax Number	:

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

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	04/13/2026

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