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Individual
MR. KENNETH D. LYONS
Active
Individual
MR. KENNETH D. LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101183
NC
363AM0700X
Medical Physician Assistant
101183
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101183
MEDICAL BOARD NUMBER
NC
05
—
ZA0000009
—
NC
Enumeration date
01/25/2007
Last updated
10/02/2020
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