Individual
DR. CRAIG R. LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 BROAD ST SE, GAINESVILLE, GA 30501-3751
(770) 718-9776
Mailing address
425 BROAD ST SE, GAINESVILLE, GA 30501-3751
(770) 718-9776
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
00025981
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009980095
—
AL
05
—
553281085B
—
GA
01
—
P00725554
RAILROAD MEDICARE
GA
Enumeration date
12/09/2005
Last updated
09/03/2010
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