Individual
FORREST LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
Mailing address
1665 S GREEN ST, TUPELO, MS 38804-6556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28274
MS
Other
Enumeration date
06/17/2019
Last updated
07/06/2022
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