Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 01026301A | IN |
NPI | 1528040045 |
---|---|
Provider Name | Dr. Kyle D. Loy |
First Address | Lafayette, IN 47909-9192 |
Second Address | Lafayette, IN 47909-9192 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 01/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000361234 | ANTHEM PIN (01) | IN |
100124630B | (05) | IN |
B28713 | (02) | IN |
P00215064 | MEDICARE RAILROAD (01) | IN |