Provider Demographics
NPI:1578874681
Name:LYON, REGAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:REGAN
Middle Name:F
Last Name:LYON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1638 OWEN DR
Mailing Address - Street 2:ATTN: MANAGED CARE PLANNING
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3424
Mailing Address - Country:US
Mailing Address - Phone:910-615-6949
Mailing Address - Fax:910-615-9761
Practice Address - Street 1:6387 RAMSEY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9441
Practice Address - Country:US
Practice Address - Phone:910-615-3879
Practice Address - Fax:910-321-6223
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2014-10-23
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Provider Licenses
StateLicense IDTaxonomies
NC2013-01649207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCH674BMedicare PIN