Organization
WILLIAM D. LYLES, JR., M.D. AND ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM D LYLES JR. M.D. (CEO)
(615) 374-0703
Entity
Organization
Contact information
Practice address
205 BROADWAY, HARTSVILLE, TN 37074-1303
(615) 374-0703
(615) 374-0019
Mailing address
PO BOX 483, HARTSVILLE, TN 37074-0483
(615) 374-0703
(615) 374-0019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16864
TN
207V00000X
Obstetrics & Gynecology Physician
16864
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3727762
—
TN
01
—
4097932
BLUECROSS BLUESHIELD
TN
Enumeration date
07/07/2006
Last updated
01/26/2012
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