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NPI 1588292403

NPI 1588292403 : MATTHEW S LYMAN MD : CENTERVILLE, OH

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General NPI Number Information
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    NPI Number           |    1588292403
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    Entity Type          |    Individual 
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    Provider Name        |    MATTHEW S LYMAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/27/2020
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    Last Update Date     |    01/25/2024
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Provider Practice Location Address
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    Address Line         |    1023 S MAIN ST STE 200 
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    City                 |    CENTERVILLE
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    State                |    OH
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    Zip                  |    45458-4358
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    Country              |    US
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    Telephone            |    937-436-3117
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    Fax                  |    937-436-0730
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Provider Business Mailing Address
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    Address Line         |    2145 N FAIRFIELD RD STE 100 
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    City                 |    BEAVERCREEK
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    State                |    OH
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    Zip                  |    45431-2783
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    Country              |    US
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    Telephone            |    937-558-3900
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    Fax                  |    937-558-3999
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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       |    35.143811
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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