Healthcare Provider Details

I. General information

NPI: 1437658630
Provider Name (Legal Business Name): LYONS FAMILY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2018
Last Update Date: 02/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1678 MONTGOMERY HWY STE 104
VESTAVIA HILLS AL
35216-4900
US

IV. Provider business mailing address

349 HERITAGE DR
VESTAVIA HILLS AL
35216-5800
US

V. Phone/Fax

Practice location:
  • Phone: 205-910-9932
  • Fax:
Mailing address:
  • Phone: 205-910-9932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EBONEE LYONS
Title or Position: OWNER
Credential: DNP
Phone: 205-910-9932