MEDICARE: RICHARD ALAN LLOYD 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	2084P0804X	Child & Adolescent Psychiatry Physician	G14285	CA
2	2084P0800X	Psychiatry Physician	E-0462	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16224000000	OTHER	AR	QUALCHOICE QCA
2	5640243	OTHER	AR	AETNA
3	5J698	OTHER	AR	BLUE CROSS

General Provider Information

NPI Number	:	1437185451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ALAN LLOYD MD

Provider Business Mailing Address
First Line	:	4253 N CROSSOVER RD
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-4593
Country	:	US
Telephone Number	:	479-521-5731
Fax Number	:	479-521-4926

Provider Business Practice Location Address
First Line	:	4253 N CROSSOVER RD
Second Line	:	SUITE 2
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-4593
Country	:	US
Telephone Number	:	479-521-5731
Fax Number	:	479-521-4926

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	08/09/2007

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