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Individual

MARK L LLOYD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2235 E GALA ST, MERIDIAN, ID 83642-8026
(208) 887-3724
(208) 887-1682
Mailing address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-1702
(208) 342-7042

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M-7100
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010002020
BLUE SHIELD OF IDAHO
ID
05
003791501
ID
01
286255
OREGON HEALTH AND WELFARE
ID
01
DK424
BLUE CROSS OF IDAHO
ID
01
P00209918
RAILROAD MEDICARE
ID
Enumeration date
09/20/2005
Last updated
02/15/2011
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