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General NPI Number Information
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NPI Number | 1831185099
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Entity Type | Individual
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Provider Name | ROBERT A LYTLE MD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 51 MAIN ST
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City | HYANNIS
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State | MA
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Zip | 02601-3109
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Country | US
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Telephone | 508-771-6447
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Fax | 508-775-5104
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Provider Business Mailing Address
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Address Line | 51 MAIN ST
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City | HYANNIS
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State | MA
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Zip | 02601-3109
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Country | US
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Telephone | 508-771-6447
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Fax | 508-775-5104
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 54395
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License Number State | MA
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