Healthcare Provider Details

I. General information

NPI: 1255564290
Provider Name (Legal Business Name): CHRISTOPHER M LYON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 REGENCY RD
LEXINGTON KY
40503-2954
US

IV. Provider business mailing address

PO BOX 737100
CHICAGO IL
60673-6374
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-1316
  • Fax: 859-276-3847
Mailing address:
  • Phone: 859-278-1316
  • Fax: 859-276-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number42977
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number42977
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number42977
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: