Provider Demographics
NPI:1427054626
Name:SMITH, LLOYD HAMLIN (M D)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:HAMLIN
Last Name:SMITH
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 MEDICAL OFFICE PL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9417
Mailing Address - Country:US
Mailing Address - Phone:919-580-0004
Mailing Address - Fax:919-580-9099
Practice Address - Street 1:2604 MEDICAL OFFICE PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9417
Practice Address - Country:US
Practice Address - Phone:919-580-0004
Practice Address - Fax:919-580-9099
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25440207PE0004X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
77964OtherBLUE CROSS BLUE SHIELD
NC8977964Medicaid
C86505Medicare UPIN
210537CMedicare PIN
77964OtherBLUE CROSS BLUE SHIELD