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Individual

CHARLES MONROE LYON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD FACS

Contact information

Practice address
4311 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(505) 556-6855
Mailing address
1900 N OREGON ST, SUITE 400, EL PASO, TX 79902-3351
(915) 533-8118
(915) 533-9669

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
98325
NM
208600000X
Surgery Physician
D7623
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
W6043
NM
Enumeration date
08/31/2005
Last updated
07/08/2007
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