Provider Demographics
NPI:1992967392
Name:LOYD, ROBERT MICHEAL JR (LMP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHEAL
Last Name:LOYD
Suffix:JR
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S HOSMER ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3146
Mailing Address - Country:US
Mailing Address - Phone:253-503-1622
Mailing Address - Fax:
Practice Address - Street 1:1941 S HOSMER ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3146
Practice Address - Country:US
Practice Address - Phone:253-503-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024511174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist