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Organization

MT VERNON FAMILY MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES BRADLEY LYONS D.O. (OWNER)
(770) 350-9100
Entity
Organization

Contact information

Practice address
1705 MOUNT VERNON RD STE A, DUNWOODY, GA 30338-4257
(770) 350-9100
(770) 350-9226
Mailing address
1705 MOUNT VERNON RD STE A, DUNWOODY, GA 30338-4257
(770) 350-9100
(770) 350-9226

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
037603
GA

Other

Enumeration date
05/21/2012
Last updated
05/21/2012
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