MEDICARE: CHARLES ELIOT LYON M.D.

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
1	207WX0107X	Retina Specialist (Ophthalmology) Physician	016354	LA
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	M2383	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558380303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES ELIOT LYON M.D.

Provider Business Mailing Address
First Line	:	836 OLIVE ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-2102
Country	:	US
Telephone Number	:	318-222-8421
Fax Number	:	318-222-0651

Provider Business Practice Location Address
First Line	:	836 OLIVE ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-2102
Country	:	US
Telephone Number	:	318-222-8421
Fax Number	:	318-222-0651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	04/07/2017

Similar Medicare Providers

1265545644 — DR. NEIL W BROGDEN OD
Practice Location Address:

VITREO-RETINAL ASSOCIATES , 836 OLIVE STREET
SHREVEPORT, LA
71104-2102

Practice Phone: 318-222-8421
Practice Fax: 318-673-9972

1689789562 — CHARLES E LYON, MD, APMC
Practice Location Address:

836 OLIVE ST
SHREVEPORT, LA
71104-2102

Practice Phone: 318-222-8421
Practice Fax: 318-673-8970

1932488525 — GREGORY P GUERIN MA, LPC
Practice Location Address:

154 ALBANY AVE
SHREVEPORT, LA
71105-2102

Practice Phone: 318-349-5590
Practice Fax: 833-851-7335

1578729208 — ST. MATTHEW'S DIRECT CARE SERVICE
Practice Location Address:

2620 CENTENARY BLVD , BLDG 1 SUITE 104
SHREVEPORT, LA
71104-3356

Practice Phone: 318-213-2273
Practice Fax: 318-213-2275

1417113267 — ST. MATTHEW'S DIRECT CARE SERVICE
Practice Location Address:

2620 CENTENARY BLVD , BLDG 1 SUITE 104
SHREVEPORT, LA
71104-3356

Practice Phone: 318-213-2273
Practice Fax: 318-213-2275

1679733836 — ST. MATTHEW'S DIRECT CARE SERVICE
Practice Location Address:

2620 CENTENARY BLVD , BLDG 1 SUITE 104
SHREVEPORT, LA
71104-3356

Practice Phone: 318-213-2273
Practice Fax: 318-213-2275

Directions to “ CHARLES ELIOT LYON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.