Organization
LLOYD D. SMITH JR., M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LLOYD SMITH (OWNER)
(209) 521-2748
Entity
Organization
Contact information
Practice address
1729 TULLY RD, #7, MODESTO, CA 95350-4082
(209) 521-2748
Mailing address
PO BOX 576188, MODESTO, CA 95357-6188
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
0G9623
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000G96230
—
CA
01
—
221169605
MEDICARE ID
CA
Enumeration date
10/05/2007
Last updated
11/24/2009
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