Provider Demographics
NPI:1487201257
Name:LYONS, JAMES CURTIS (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CURTIS
Last Name:LYONS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 MARYCREST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-5074
Mailing Address - Country:US
Mailing Address - Phone:318-751-9100
Mailing Address - Fax:318-751-9101
Practice Address - Street 1:1715 MARYCREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-5074
Practice Address - Country:US
Practice Address - Phone:318-751-9100
Practice Address - Fax:318-751-9101
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA03184208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPT.03184OtherSTATE LICENSE