Healthcare Provider Details

I. General information

NPI: 1528644697
Provider Name (Legal Business Name): ARTHUR JAMES LYON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 OLD YORK RD STE 1
PHILADELPHIA PA
19141-3098
US

IV. Provider business mailing address

5501 OLD YORK RD STE 1
PHILADELPHIA PA
19141-3098
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-6636
  • Fax:
Mailing address:
  • Phone: 215-456-6636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34953
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number34953
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: