# MT VERNON FAMILY MEDICINE

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

## Provider details

- **NPI number:** 1982964219
- **Authorized official:** CHARLES BRADLEY LYONS D.O. (OWNER)
- **Authorized official phone:** (770) 350-9100

## Contact information

- **Practice address:** 1705 MOUNT VERNON RD STE A, DUNWOODY, GA 30338-4257
- **Practice address phone:** (770) 350-9100
- **Practice address fax:** (770) 350-9226
- **Mailing address:** 1705 MOUNT VERNON RD STE A, DUNWOODY, GA 30338-4257
- **Mailing address phone:** (770) 350-9100
- **Mailing address fax:** (770) 350-9226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 037603 | GA | Yes |

## Other

- **Enumeration date:** 05/21/2012
- **Last updated:** 05/21/2012