Individual
ROBERT A LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1623 S. WELLS AVENUE, MERIDIAN, ID 83642
(208) 489-1450
(208) 489-1451
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8869
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806678200
—
ID
Enumeration date
06/02/2006
Last updated
04/11/2014
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