Provider Demographics
NPI:1215476809
Name:LLOYD PODIATRY GROUP, INC.
Entity type:Organization
Organization Name:LLOYD PODIATRY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:765-642-3000
Mailing Address - Street 1:2117 E. 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012
Mailing Address - Country:US
Mailing Address - Phone:765-642-3000
Mailing Address - Fax:765-642-3074
Practice Address - Street 1:9669 E. 146TH STREET
Practice Address - Street 2:SUITE 148
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060
Practice Address - Country:US
Practice Address - Phone:317-842-1361
Practice Address - Fax:765-642-3074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000551A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INT35060Medicare UPIN