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General NPI Number Information
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NPI Number | 1043378060
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Entity Type | Individual
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Provider Name | LAWRENCE LYONS MD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 06B MAIN STREET
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City | CERRILLOS
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State | NM
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Zip | 87010
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Country | US
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Telephone | 505-471-6266
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Fax | 505-471-5861
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Provider Business Mailing Address
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Address Line | PO BOX 2267
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City | SANTA FE
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State | NM
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Zip | 87504-2267
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Country | US
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Telephone | 505-820-3478
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Fax | 505-989-4761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 77-213
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License Number State | NM
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