Individual
JONATHAN LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9879 KY ROUTE 122, MC DOWELL, KY 41647-6026
(606) 377-3427
(606) 377-3466
Mailing address
100 AIRPORT GARDENS ROAD, CREDENTIALING AND PROVIDER ENROLLMENT, HAZARD, KY 41701
(606) 487-7503
(606) 432-5363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04160
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100510970
—
KY
Enumeration date
04/16/2015
Last updated
06/30/2022
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