Organization
ROBERT E LYON INTERNAL MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E LYON M.D. (OWNER)
(318) 281-3432
Entity
Organization
Contact information
Practice address
420 GUNBY AVE, BASTROP, LA 71220-4406
(318) 281-3432
(318) 281-8850
Mailing address
420 GUNBY AVE, BASTROP, LA 71220-4406
(318) 281-3432
(318) 281-8850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
015059
LA
207R00000X
Internal Medicine Physician
Primary
014103
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1302112
—
LA
Enumeration date
08/04/2009
Last updated
08/04/2009
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