Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD448114 | PA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 49239 | AZ |
NPI | 1285953166 |
---|---|
Provider Name | Dr. Jarem B. Lloyd |
First Address | Flagstaff, AZ 86001 |
Second Address | Kingman, AZ 86401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2010 |
Last Update Date | 13/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
914114 | (05) | AZ |