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NPI Code Detail

MEDICARE: WESLEY JOHN LYON PA

MEDICARE: WESLEY JOHN LYON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantVA
2363A00000XPhysician Assistant0010-03870NC

General Provider Information

NPI Number : 1083931935
Entity Type Code : Individual
Provider Name (Legal Business Name) : WESLEY JOHN LYON PA
Provider Business Mailing Address
First Line : PO BOX 654481
Second Line :
City : DALLAS
State : TX
Zip : 75265-4481
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 509 BILTMORE AVE
Second Line :
City : ASHEVILLE
State : NC
Zip : 28801-4601
Country : US
Telephone Number : 828-213-3524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2010
Last Update Date : 06/22/2026

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