MEDICARE: MEGAN LYONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	9520	AZ

General Provider Information

NPI Number	:	1306556162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN LYONS

Provider Business Mailing Address
First Line	:	6234 W BEHREND DR APT 1102
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-6908
Country	:	US
Telephone Number	:	520-334-7782
Fax Number	:

Provider Business Practice Location Address
First Line	:	19636 N 27TH AVE STE 206
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-4015
Country	:	US
Telephone Number	:	602-788-0088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2022
Last Update Date	:	07/08/2024

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Directions to “ MEGAN LYONS ” Practice Location

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