Provider Demographics
NPI:1285658237
Name:LYONS, DARRIN (MD)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:
Last Name:LYONS
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 1:7243 HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38060-3403
Mailing Address - Country:US
Mailing Address - Phone:901-465-9902
Mailing Address - Fax:901-465-2110
Practice Address - Street 1:7243 HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:TN
Practice Address - Zip Code:38060-3403
Practice Address - Country:US
Practice Address - Phone:901-465-9902
Practice Address - Fax:901-465-2110
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000030795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3890747Medicaid
TN3890747Medicare ID - Type Unspecified
TN3890747Medicaid