Provider Demographics
NPI:1710918560
Name:LYONS, MARY JOYCE (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JOYCE
Last Name:LYONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:JOYCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD
Mailing Address - Street 2:STE 5
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-1210
Practice Address - Street 1:835 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3188
Practice Address - Country:US
Practice Address - Phone:508-541-8000
Practice Address - Fax:508-541-6749
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77531208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3111610Medicaid
MA3111610Medicaid
J14223Medicare ID - Type Unspecified