Individual
DR. JACQUELINE MARIE LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
580 COURT ST, KEENE, NH 03431-1718
(603) 354-5400
Mailing address
6 STRATFORD PARK, BLOOMFIELD, CT 06002-2143
(860) 242-3308
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
027112
CT
2085R0001X
Radiation Oncology Physician
Primary
13975
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001271121
—
CT
01
—
0143311-011
CIGNA
CT
01
—
06-1062103
UNITED HEATHCARE
CT
01
—
0S2354
HEATHNET
CT
01
—
2045943
AETNA
CT
01
—
458887
CONNECTICARE
CT
01
—
500HBX099CT01
ANTHEM/HARTFORD
CT
01
—
500HBX099CT02
ANTHEM/UCONN
CT
01
—
500HBX099CT04
ANTHEM/DEQUATTRO
CT
01
—
500HBX099CT05
ANTHEM/PHOENIX
CT
Enumeration date
08/11/2005
Last updated
08/15/2023
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