Individual
CHARLES B LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1705-A MOUNT VERNON RD, ATLANTA, GA 30338
(770) 350-9100
Mailing address
1705-A MOUNT VERNON RD, ATLANTA, GA 30338
(770) 350-9100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
037603
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000737118E
—
GA
Enumeration date
09/20/2006
Last updated
03/29/2010
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