Individual
CHARLES ELIOT LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
836 OLIVE ST, SHREVEPORT, LA 71104-2102
(318) 222-8421
(318) 222-0651
Mailing address
836 OLIVE ST, SHREVEPORT, LA 71104-2102
(318) 222-8421
(318) 222-0651
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
016354
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
M2383
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1352543
—
LA
Enumeration date
07/19/2006
Last updated
04/07/2017
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