Basic Information
| Provider Information | |||||||||
| NPI: | 1508832155 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LYON | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 611 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | STANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488889702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895843131 | ||||||||
| FaxNumber: | 9895846734 | ||||||||
| Practice Location | |||||||||
| Address1: | 611 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | STANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488889702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895843131 | ||||||||
| FaxNumber: | 9895846734 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2006 | ||||||||
| LastUpdateDate: | 10/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 5101014171 | MI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.