Organization
JOHN P LYLES OPTOMETRIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LYLES O.D. (OPTOMETRIST)
(270) 395-8331
Entity
Organization
Contact information
Practice address
43 INDUSTRIAL PARKWAY, CALVERT CITY, KY 42029
(270) 395-8331
(270) 395-5360
Mailing address
PO BOX 7451, PADUCAH, KY 42002-7451
(270) 443-9904
(270) 575-0717
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1292DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000058828
BCBS KY
KY
Enumeration date
11/29/2007
Last updated
03/15/2011
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