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General NPI Number Information
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NPI Number | 1063476364
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Entity Type | Individual
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Provider Name | KENT J. LYON MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 700 SUNSET DR STE 601
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City | ATHENS
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State | GA
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Zip | 30606-7720
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Country | US
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Telephone | 706-549-4155
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Fax | 706-546-0036
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Provider Business Mailing Address
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Address Line | 700 SUNSET DR STE 601
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City | ATHENS
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State | GA
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Zip | 30606-7720
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Country | US
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Telephone | 706-549-4155
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Fax | 706-546-0036
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 83749
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License Number State | GA
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