Provider Demographics
NPI:1841239977
Name:LYONS, JAMES P (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:LYONS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:445 FACTORY ST
Mailing Address - Street 2:PO BOX 91
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-2729
Mailing Address - Country:US
Mailing Address - Phone:315-782-4207
Mailing Address - Fax:315-782-8699
Practice Address - Street 1:190 OUTER MAIN ST
Practice Address - Street 2:NATCO BLDG
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-2324
Practice Address - Country:US
Practice Address - Phone:315-265-2153
Practice Address - Fax:315-265-2540
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-04-21
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Provider Licenses
StateLicense IDTaxonomies
NY156476207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01155288Medicaid
NYRB5171Medicare PIN
NYBB2358Medicare PIN
NYE51419Medicare UPIN