| Robert E Lyon Internal Medicine, Inc. | |
|
420 Gunby Ave Bastrop LA 71220-4406 | |
| (318) 281-3432 | |
| (318) 281-8850 |
| Full Name | Robert E Lyon Internal Medicine, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 420 Gunby Ave, Bastrop, Louisiana |
| Authorized Official Name and Position | Robert E Lyon (OWNER) |
| Authorized Official Contact | 3182813432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert E Lyon Internal Medicine, Inc. 420 Gunby Ave Bastrop LA 71220-4406 Ph: (318) 281-3432 | Robert E Lyon Internal Medicine, Inc. 420 Gunby Ave Bastrop LA 71220-4406 Ph: (318) 281-3432 |
| NPI Number | 1225265598 |
|---|---|
| Provider Enumeration Date | 06/15/2009 |
| Last Update Date | 06/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225265598 | NPI | - | NPPES |
| 1302112 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 015059 (Louisiana) | Secondary |
| 207R00000X | Internal Medicine | 014103 (Louisiana) | Primary |
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