MEDICARE: DR JENIFER R LLOYD LLC

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	207N00000X	Dermatology Physician	34004266	OH

General Provider Information

NPI Number	:	1629385737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JENIFER R LLOYD LLC

Provider Business Mailing Address
First Line	:	8060 MARKET ST
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-6241
Country	:	US
Telephone Number	:	330-758-9189
Fax Number	:	330-758-4487

Provider Business Practice Location Address
First Line	:	8060 MARKET ST
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-6241
Country	:	US
Telephone Number	:	330-758-9189
Fax Number	:	330-758-4487

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	JENIFER R LLOYD
Credential	:	D.O.
Telephone Number	:	330-758-9189

Provider Enumeration Date	:	09/10/2010
Last Update Date	:	11/15/2010

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