Healthcare Provider Details

I. General information

NPI: 1346440062
Provider Name (Legal Business Name): FRANK LYONS DO, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 E TOM T HALL BLVD
OLIVE HILL KY
41164-7040
US

IV. Provider business mailing address

775 E TOM T HALL BLVD
OLIVE HILL KY
41164-7040
US

V. Phone/Fax

Practice location:
  • Phone: 606-286-5065
  • Fax:
Mailing address:
  • Phone: 606-286-5065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number02947
License Number StateKY

VIII. Authorized Official

Name: ROBIN DEERE
Title or Position: BILLING MGR
Credential:
Phone: 606-371-2369