Provider Demographics
NPI:1063783256
Name:SAMUEL J. LLOYD MD PC
Entity type:Organization
Organization Name:SAMUEL J. LLOYD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:540-347-9450
Mailing Address - Street 1:550 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186
Mailing Address - Country:US
Mailing Address - Phone:540-347-9450
Mailing Address - Fax:
Practice Address - Street 1:550 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-347-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025875207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA625515Medicaid
VA625515Medicaid
162930119Medicare PIN