Basic Information
| Provider Information | |||||||||
| NPI: | 1750316444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLOYD | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | IV | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 936 | ||||||||
| Address2: | |||||||||
| City: | LONDON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 407430936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063307818 | ||||||||
| FaxNumber: | 6063307825 | ||||||||
| Practice Location | |||||||||
| Address1: | 1451 HARRODSBURG RD | ||||||||
| Address2: | SUITE D 302 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405043758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8599770898 | ||||||||
| FaxNumber: | 8592601278 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | 26079 | KY | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208600000X | 26079 | KY | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 37903705 | 01 | KY | MEDICAID GROUP LAB | OTHER | 020015921 | 01 | KY | RR MEDICARE PIN | OTHER | 64260797 | 05 | KY | MEDICAID | ASC1019 | 01 | KY | ASC MEDICARE GROUP | OTHER | 36000818 | 01 | KY | ASC MEDICAID GROUP | OTHER | CB5773 | 01 | KY | RR MEDICARE GROUP | OTHER | 4000501 | 01 | KY | MEDICARE LAB | OTHER |