Individual
EZRA LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
710 RIVERSIDE DR, WAUPACA, WI 54981-1941
(715) 256-3000
(715) 256-3079
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(715) 256-3000
(715) 256-3079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69896
WI
207VX0000X
Obstetrics Physician
69896
WI
Other
Enumeration date
04/12/2017
Last updated
02/11/2025
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