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Individual

JOHN BENTON LYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1431 W 10TH ST, SUITE 2, LAUREL, MS 39440-2626
(601) 649-2450
(601) 649-0556
Mailing address
PO BOX 1965, LAUREL, MS 39441-1965
(601) 649-2450
(601) 649-0556

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17566
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000125873
MS
Enumeration date
12/06/2006
Last updated
11/21/2022
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