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General NPI Number Information
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NPI Number | 1639349780
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Entity Type | Organization
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Legal Business Name | JOHN P. LYDON, D.P.M.
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 5620 SHIELDS DR
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City | BETHESDA
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State | MD
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Zip | 20817-3532
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Country | US
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Telephone | 301-530-4181
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Fax | 301-530-4373
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Provider Business Mailing Address
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Address Line | 5620 SHIELDS DR
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City | BETHESDA
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State | MD
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Zip | 20817-3532
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Country | US
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Telephone | 301-530-4181
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Fax | 301-530-4373
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. JOHN P. LYDON
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Credential | D.P.M.
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Telephone | 301-530-4181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 00580
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License Number State | MD
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