# ROBERT E LYON INTERNAL MEDICINE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801027131
- **Authorized official:** DR. ROBERT E LYON M.D. (OWNER)
- **Authorized official phone:** (318) 281-3432

## Contact information

- **Practice address:** 420 GUNBY AVE, BASTROP, LA 71220-4406
- **Practice address phone:** (318) 281-3432
- **Practice address fax:** (318) 281-8850
- **Mailing address:** 420 GUNBY AVE, BASTROP, LA 71220-4406
- **Mailing address phone:** (318) 281-3432
- **Mailing address fax:** (318) 281-8850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 015059 | LA | — |
| 207R00000X | Internal Medicine Physician | 014103 | LA | Yes |

## Other

- **Enumeration date:** 08/04/2009
- **Last updated:** 08/04/2009