Basic Information
| Provider Information | |||||||||
| NPI: | 1932171618 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LLOYD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | K | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 AINSWORTH DR STE 115 | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863051664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9288489730 | ||||||||
| FaxNumber: | 9284438473 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 AINSWORTH DR STE 115 | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863051667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9288489730 | ||||||||
| FaxNumber: | 9284438473 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 07/25/2011 | ||||||||
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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 | 2085R0202X | MD2004-0761 | NM | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 10020655 | 01 | LOVELACE HEALTH/SALUD | OTHER | 19838735 | 05 | NM | MEDICAID | 201049623 | 01 | PRESBYTERIAN HEALTH/SALUD | OTHER | 915548 | 05 | AZ | MEDICAID | QMYPR0068672 | 01 | MOLINA | OTHER | P00201712 | 01 | RAILROAD MEDICARE | OTHER |