Provider Demographics
NPI:1083692040
Name:LYRAS, LOUIS SOZON (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:SOZON
Last Name:LYRAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7645 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6098
Mailing Address - Country:US
Mailing Address - Phone:330-726-0156
Mailing Address - Fax:330-707-0618
Practice Address - Street 1:7645 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6098
Practice Address - Country:US
Practice Address - Phone:330-726-0156
Practice Address - Fax:330-707-0618
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042474L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0533373Medicaid
OHA80623Medicare UPIN
OH0530952Medicare ID - Type Unspecified