Provider Demographics
NPI:1497725212
Name:LYONS, SOMER JOHNSON (OD)
Entity Type:Individual
Prefix:DR
First Name:SOMER
Middle Name:JOHNSON
Last Name:LYONS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 JACKDAW LN
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89704-9719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1687 US HIGHWAY 395 N
Practice Address - Street 2:#2
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4321
Practice Address - Country:US
Practice Address - Phone:775-783-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV489152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101319Medicare PIN
NVU99359Medicare UPIN