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General NPI Number Information
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NPI Number | 1750395067
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Entity Type | Organization
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Legal Business Name | LYONS ANESTHESIA, INC.
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 140 FOX RD SUITE 207
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City | VAN WERT
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State | OH
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Zip | 45891-2475
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Country | US
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Telephone | 419-232-2866
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Fax | 419-232-2867
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Provider Business Mailing Address
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Address Line | 140 FOX RD SUITE 207
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City | VAN WERT
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State | OH
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Zip | 45891-2475
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Country | US
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Telephone | 419-232-2866
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Fax | 419-232-2867
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOMMY W LYONS
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Credential | CRNA
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Telephone | 419-232-2866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN271691
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License Number State | OH
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