Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00288400 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | SC005805 | PA |
NPI | 1043275340 |
---|---|
Provider Name | Dr. Kevin Scott Lyons |
First Address | Voorhees, NJ 08043-2601 |
Second Address | Voorhees, NJ 08043-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 07/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T87578 | (02) |