Provider Demographics
NPI:1326043308
Name:LYONS, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:LYONS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:331 OLCOTT DR
Mailing Address - Street 2:STE U3
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-9601
Mailing Address - Country:US
Mailing Address - Phone:802-295-6132
Mailing Address - Fax:802-295-1358
Practice Address - Street 1:331 OLCOTT DR
Practice Address - Street 2:STE U3
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-9601
Practice Address - Country:US
Practice Address - Phone:802-295-6132
Practice Address - Fax:802-295-1358
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-03-29
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Provider Licenses
StateLicense IDTaxonomies
VT042-0009196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1243Medicaid
VT8000340Medicaid
VT0VN1243Medicaid
VT8000340Medicaid