Provider Demographics
NPI:1215923040
Name:FLOYD, JOANNE L (MD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:L
Last Name:FLOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 S 7TH ST
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-5710
Mailing Address - Country:US
Mailing Address - Phone:812-232-5900
Mailing Address - Fax:812-232-2370
Practice Address - Street 1:3903 S 7TH ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5710
Practice Address - Country:US
Practice Address - Phone:812-232-5900
Practice Address - Fax:812-232-2370
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037594174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100252320Medicaid
IN100252320Medicaid