Individual
JEFFREY EDMUND LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29869
MN
208M00000X
Hospitalist Physician
Primary
29869
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163387200
—
MN
05
—
32003700
—
WI
Enumeration date
07/10/2006
Last updated
11/01/2017
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