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General NPI Number Information
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NPI Number | 1356640379
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Entity Type | Individual
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Provider Name | MARTIN ANTHONY LYONS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 41 CAMBRIDGE CT
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City | WETUMPKA
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State | AL
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Zip | 36093-1261
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Country | US
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Telephone | 334-567-3309
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Fax | 334-567-5692
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Provider Business Mailing Address
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Address Line | 41 CAMBRIDGE CT
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City | WETUMPKA
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State | AL
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Zip | 36093-1261
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Country | US
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Telephone | 334-567-3309
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Fax | 334-567-5692
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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 | 30815
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License Number State | AL
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