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General NPI Number Information
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NPI Number | 1497493779
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Entity Type | Individual
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Provider Name | CHRISTOPHER LYONS
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Gender | Male
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 4424 E FLAMINGO AVE STE 200
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City | NAMPA
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State | ID
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Zip | 83687-9300
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Country | US
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Telephone | 208-302-7100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190930
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City | BOISE
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State | ID
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Zip | 83719-0930
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Country | US
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Telephone | 208-302-9342
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5471054
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R-12504
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License Number State | IA
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