# CHARLES E LYON, MD, APMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VITREO-RETINAL ASSOCIATES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689789562
- **Authorized official:** CHARLES E LYON SR. MD (PRESIDENT)
- **Authorized official phone:** (318) 222-8421

## Contact information

- **Practice address:** 836 OLIVE ST, SHREVEPORT, LA 71104-2102
- **Practice address phone:** (318) 222-8421
- **Practice address fax:** (318) 673-8970
- **Mailing address:** 836 OLIVE ST, SHREVEPORT, LA 71104-2102
- **Mailing address phone:** (318) 222-8421
- **Mailing address fax:** (318) 673-8970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 09/11/2025