Provider Demographics
NPI:1386812873
Name:BENTLEY, LLOYD KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:KENNETH
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W PALO VERDE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2355
Mailing Address - Country:US
Mailing Address - Phone:480-821-5888
Mailing Address - Fax:
Practice Address - Street 1:1110 W PALO VERDE DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2355
Practice Address - Country:US
Practice Address - Phone:480-821-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ82712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry