1659421865 NPI number — DR. HEATHER GOTTFRIED LLOYD M.D.

Table of content: DR. HEATHER GOTTFRIED LLOYD M.D. (NPI 1659421865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659421865 NPI number — DR. HEATHER GOTTFRIED LLOYD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LLOYD
Provider First Name:
HEATHER
Provider Middle Name:
GOTTFRIED
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOTTFRIED
Provider Other First Name:
HEATHER
Provider Other Middle Name:
SHERENE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659421865
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 LA RUE CT.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANDLER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28715-8969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-808-6937
Provider Business Mailing Address Fax Number:
828-665-4173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
68 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYLVA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28779-2722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-586-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  200600949 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)