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NPI Code Detail

MEDICARE: JOHN ANTHONY LYON

MEDICARE: JOHN ANTHONY LYON
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1710827670
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ANTHONY LYON
Provider Business Mailing Address
First Line : 101 STADIUM DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-7911
Country : US
Telephone Number : 304-598-4850
Fax Number : 304-598-4871
Provider Business Practice Location Address
First Line : 101 STADIUM DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-7911
Country : US
Telephone Number : 304-598-4850
Fax Number : 304-598-4871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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