Healthcare Provider Details

I. General information

NPI: 1437137403
Provider Name (Legal Business Name): CLIFFORD HAYES LYONS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 FORGE DAM RD
HAMBURG PA
19526-7971
US

IV. Provider business mailing address

16 FORGE DAM RD
HAMBURG PA
19526-7971
US

V. Phone/Fax

Practice location:
  • Phone: 610-488-0788
  • Fax:
Mailing address:
  • Phone: 610-488-0788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD031996-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: