Provider Demographics
NPI:1558362962
Name:LYET, JEAN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:PAUL
Last Name:LYET
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 1:4 SOUTHVIEW LN
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8207
Mailing Address - Country:US
Mailing Address - Phone:717-572-9444
Mailing Address - Fax:717-627-5058
Practice Address - Street 1:4 SOUTHVIEW LN
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-8207
Practice Address - Country:US
Practice Address - Phone:717-572-9444
Practice Address - Fax:717-627-5058
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024483E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4359OtherHIGHMARK BLUE SHIELD
PA200030730OtherRAILROAD MEDICARE
PA4359OtherHIGHMARK BLUE SHIELD
PAD67925Medicare UPIN