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NPI Code Detail

MEDICARE: ELIZABETH A LYONS P.A.

MEDICARE: ELIZABETH A LYONS P.A.
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
1363A00000XPhysician Assistant5601004228MI

General Provider Information

NPI Number : 1942270632
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH A LYONS P.A.
Provider Business Mailing Address
First Line : 23550 HAGGERTY RD
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48335-2614
Country : US
Telephone Number : 248-381-8081
Fax Number : 734-402-0254
Provider Business Practice Location Address
First Line : 23550 HAGGERTY RD
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48335-2614
Country : US
Telephone Number : 248-381-8081
Fax Number : 734-402-0254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 03/09/2009

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