Individual
DR. ROGER M LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-6000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34470
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000125E
HUMANA
—
05
—
1518918366
—
WI
05
—
31956500
—
WI
Enumeration date
05/15/2006
Last updated
08/26/2024
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