Individual
JO MARIE LYONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
428 WINN CT, DECATUR, GA 30030-1726
(770) 384-0284
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
031786
GA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
031786
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000392972D
—
GA
01
—
13BDDRC01
MEDICARE ID
GA
Enumeration date
09/13/2006
Last updated
07/21/2022
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