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General NPI Number Information
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NPI Number | 1528173242
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Entity Type | Individual
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Provider Name | STEPHEN A LYRENE MD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 1836 SOUTH AVE
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City | LA CROSSE
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State | WI
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Zip | 54601-5429
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Country | US
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Telephone | 608-782-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 835 PEBBLE BEACH DR
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City | MADISON
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State | WI
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Zip | 53717-1171
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Country | US
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Telephone | 251-680-1437
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 17947
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 65168
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License Number State | WI
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