Basic Information
Provider Information
NPI: 1386876795
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLOYD
FirstName: LATOYA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 6010
Address2:  
City: GREAT FALLS
State: MT
PostalCode: 594066010
CountryCode: US
TelephoneNumber: 4067318888
FaxNumber: 4067318318
Practice Location
Address1: 1300 28TH ST S
Address2:  
City: GREAT FALLS
State: MT
PostalCode: 594055296
CountryCode: US
TelephoneNumber: 4067318888
FaxNumber: 4067318318
Other Information
ProviderEnumerationDate: 08/18/2009
LastUpdateDate: 04/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XMD438598PAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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