MEDICARE: LLOYDS MEDICAL SERVICES, 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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1972125870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LLOYDS MEDICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	13835 N TATUM BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-5581
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13835 N TATUM BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-5581
Country	:	US
Telephone Number	:	602-538-5100
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CECIL GRAHAM
Credential	:	MD
Telephone Number	:	602-538-5100

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	06/11/2020

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