Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 26378 | WV |
N | 207X00000X | Orthopaedic Surgeon | MD.36818 | AL |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 26378 | WV |
NPI | 1003251851 |
---|---|
Provider Name | Dana S Lycans |
First Address | Huntington, WV 25703-1225 |
Second Address | Huntington, WV 25703-1225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2013 |
Last Update Date | 16/11/2021 |