Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 050038 | AL |
NPI | 1023052610 |
---|---|
Provider Name | Dr. James E. Lyle IV |
First Address | Opelika, AL 36801 |
Second Address | Opelika, AL 36801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 12/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H37307 | (02) | AL |