Individual
CAROL A LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
240 CORPORATE CENTER DR, SUITE 200, STOCKBRIDGE, GA 30281-7214
(678) 284-9171
(770) 506-7436
Mailing address
240 CORPORATE CENTER DR, SUITE 200, STOCKBRIDGE, GA 30281-7214
(678) 284-9171
(770) 506-7436
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
024707
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00532012B
—
GA
Enumeration date
08/31/2006
Last updated
12/27/2010
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