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Individual

ALFRED GORDON LYONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
970 LAKELAND DR, 45, JACKSON, MS 39216-4635
(601) 200-4690
(601) 200-4698
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4880
(601) 200-5929

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
10603
MS
208VP0014X
Interventional Pain Medicine Physician
Primary
10603
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00115787
MS
01
P01237614
RAILROAD MEDICARE
MS
Enumeration date
09/04/2006
Last updated
10/03/2016
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