Provider Demographics
NPI:1750304549
Name:LYONS, DOROTHY ARALINE (MD)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ARALINE
Last Name:LYONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 RIVERVIEW AVE STE 202A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1065
Mailing Address - Country:US
Mailing Address - Phone:757-252-9015
Mailing Address - Fax:757-510-9041
Practice Address - Street 1:301 RIVERVIEW AVE STE 202A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1065
Practice Address - Country:US
Practice Address - Phone:757-252-9015
Practice Address - Fax:757-510-9041
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045475L204D00000X, 2084N0400X
VA01012408782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000133226OtherANTHEM
OH0626022Medicaid
OH127883100OtherUS DEPT. OF LABOR
OH127883100OtherUS DEPT. OF LABOR
OH9928492Medicare ID - Type UnspecifiedCONCORD
OH9928495Medicare ID - Type UnspecifiedASHTABULA
OH0626022Medicaid
OH341519679OtherTAX ID NUMBER