Healthcare Provider Details

I. General information

NPI: 1053268268
Provider Name (Legal Business Name): ALEXIS LYONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S MAIN ST STE C
CAVE CITY AR
72521-9224
US

IV. Provider business mailing address

80 ARKANSAS 115
CAVE CITY AR
72521-9331
US

V. Phone/Fax

Practice location:
  • Phone: 870-283-5589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17675
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: