Basic Information
Provider Information
NPI: 1033408505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLOYD
FirstName: ALICIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1515 HARMONY HEIGHTS LN
Address2:  
City: RAPID CITY
State: SD
PostalCode: 577010460
CountryCode: US
TelephoneNumber: 6467894393
FaxNumber:  
Practice Location
Address1: 301 BECKER AVE SW
Address2:  
City: WILLMAR
State: MN
PostalCode: 562013395
CountryCode: US
TelephoneNumber: 3202354543
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/05/2011
LastUpdateDate: 10/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X273528NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X71221-20WIN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X10148SDN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X273528NYN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000XDR.0062872CON Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X62438MNY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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