MEDICARE: MR. DANNY R LYONS RPT

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	225100000X	Physical Therapist	PT437	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT437	OTHER	AR	STATE LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669595153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANNY R LYONS RPT

Provider Business Mailing Address
First Line	:	408 N CHURCH ST
Second Line	:
City	:	ATKINS
State	:	AR
Zip	:	72823-4149
Country	:	US
Telephone Number	:	479-641-5500
Fax Number	:	479-641-5501

Provider Business Practice Location Address
First Line	:	408 N CHURCH ST
Second Line	:
City	:	ATKINS
State	:	AR
Zip	:	72823-4149
Country	:	US
Telephone Number	:	479-641-5500
Fax Number	:	479-641-5501

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	12/04/2025

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