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NPI Code Detail

MEDICARE: JON M LYMAN HAD

MEDICARE: JON M LYMAN HAD
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
1237700000XHearing Instrument SpecialistHAD-HAD-LIC-1211MT

General Provider Information

NPI Number : 1639539810
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON M LYMAN HAD
Provider Business Mailing Address
First Line : 317 S ORANGE ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-1810
Country : US
Telephone Number : 406-549-1951
Fax Number : 406-542-5682
Provider Business Practice Location Address
First Line : 317 S ORANGE ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-1810
Country : US
Telephone Number : 406-549-1951
Fax Number : 406-542-5682
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2016
Last Update Date : 03/10/2021

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