Provider Demographics
NPI:1366333759
Name:LYONS, MAURICE KIRKSEY (CSFA)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:KIRKSEY
Last Name:LYONS
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6027 ARMOR DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6244
Mailing Address - Country:US
Mailing Address - Phone:678-368-5178
Mailing Address - Fax:
Practice Address - Street 1:6027 ARMOR DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6244
Practice Address - Country:US
Practice Address - Phone:678-368-5178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA194015246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant