Individual
EDD GILBERT LYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1068 VAIL RD, BENNINGTON, VT 05201-9599
(802) 447-0051
Mailing address
1068 VAIL RD, BENNINGTON, VT 05201-9599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42-6255
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002387
—
VT
Enumeration date
05/08/2006
Last updated
04/15/2016
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