Healthcare Provider Details

I. General information

NPI: 1891021663
Provider Name (Legal Business Name): VAL O LYONS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 02/23/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 13TH ST
CHARLES CITY IA
50616-3443
US

IV. Provider business mailing address

801 13TH ST
CHARLES CITY IA
50616-3443
US

V. Phone/Fax

Practice location:
  • Phone: 641-228-1143
  • Fax: 641-228-7621
Mailing address:
  • Phone: 641-228-1143
  • Fax: 641-228-7621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number27531
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: VAL OWEN LYONS
Title or Position: PRESIDENT
Credential:
Phone: 641-228-1143