Provider Demographics
NPI:1982645727
Name:LYONS, VIRGLE E (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGLE
Middle Name:E
Last Name:LYONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VIRGLE
Other - Middle Name:E
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 317
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-664-2434
Mailing Address - Fax:501-664-9349
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 317
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-664-2434
Practice Address - Fax:501-664-9349
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4210173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR53252Medicare ID - Type Unspecified
ARD84237Medicare UPIN