Provider Demographics
NPI:1083656250
Name:LYONS, PAUL D (MD PHD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:LYONS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MEDICAL CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3300
Mailing Address - Country:US
Mailing Address - Phone:540-667-1828
Mailing Address - Fax:540-722-6207
Practice Address - Street 1:125A MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3322
Practice Address - Country:US
Practice Address - Phone:540-667-1828
Practice Address - Fax:540-722-6207
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012319402084N0400X, 2084P0005X, 2084S0012X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA001846010OtherMOUNTAIN STATE BCBS
VA010267749Medicaid
VA196652OtherANTHEM BCBS
VAP00349162OtherRAILROAD MEDICARE
VA001846010OtherMOUNTAIN STATE BCBS
VA130000841Medicare ID - Type Unspecified
VA010267749Medicaid