Individual
LARRY E LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1217 8TH ST N, NEW ULM, MN 56073-1552
(507) 217-5000
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
6004
SD
207Q00000X
Family Medicine Physician
Primary
20288
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
534367400
—
MN
Enumeration date
08/22/2005
Last updated
01/26/2012
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