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LLOYD E. WITHAM, M.D., P.A.

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Company Details

Name: LLOYD E. WITHAM, M.D., P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved
Date of registration: 31 Aug 1987 (38 years ago)
Financial Date End: 31 Aug 2015
Date dissolved: 04 Aug 2014
Entity Number: 263887
Place of Formation: IDAHO
File Number: 0000263887
ZIP code: 83814
County: Kootenai County
Mailing Address: 1107 IRONWOOD DRIVE COEUR D'ALENE, ID 83814

National Provider Identifier

NPI Number:
1871685321

Authorized Person:

Name:
LLOYD E WITHAM
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
No
Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
2086672631

Form 5500 Series

Employer Identification Number (EIN):
820415824
Plan Year:
2012
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
10
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Articles of Dissolution 0000827388 2014-08-04
Annual Report 0002023268 2014-07-22
Annual Report 0002023267 2013-07-18
Annual Report 0002023265 2012-07-17
Annual Report 0002023279 2011-08-15

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State