# LLOYD E. WITHAM MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871685321
- **Authorized official:** LLOYD E WITHAM MD (PHYSICIAN)
- **Authorized official phone:** (208) 667-7459

## Contact information

- **Practice address:** 1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
- **Practice address phone:** (208) 667-7459
- **Practice address fax:** (208) 667-2631
- **Mailing address:** 1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
- **Mailing address phone:** (208) 667-7459
- **Mailing address fax:** (208) 667-2631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M5216 | ID | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | M5216 | ID | — |

## Other

- **Enumeration date:** 09/29/2006
- **Last updated:** 03/27/2008