Healthcare Provider Details

I. General information

NPI: 1083656250
Provider Name (Legal Business Name): PAUL D LYONS MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125A MEDICAL CIR
WINCHESTER VA
22601-3322
US

IV. Provider business mailing address

125 MEDICAL CIR SUITE A
WINCHESTER VA
22601-3300
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-1828
  • Fax: 540-722-6207
Mailing address:
  • Phone: 540-667-1828
  • Fax: 540-722-6207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101231940
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number0101231940
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number0101231940
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number0101231940
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: