Provider Demographics
NPI:1316942758
Name:LLOYD, JENIFER R (DO)
Entity type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:R
Last Name:LLOYD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8060 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6241
Mailing Address - Country:US
Mailing Address - Phone:330-758-9189
Mailing Address - Fax:330-758-4487
Practice Address - Street 1:8060 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6241
Practice Address - Country:US
Practice Address - Phone:330-758-9189
Practice Address - Fax:330-758-4487
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-4266L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH234946Medicaid
OH234946Medicaid