Provider Demographics
NPI:1386610194
Name:LYONS, MAURICE I (DO)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:I
Last Name:LYONS
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1800 15TH ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-4500
Mailing Address - Country:US
Mailing Address - Phone:970-378-4593
Mailing Address - Fax:970-378-4591
Practice Address - Street 1:1800 15TH ST
Practice Address - Street 2:SUITE 340
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-4500
Practice Address - Country:US
Practice Address - Phone:970-378-4593
Practice Address - Fax:970-378-4591
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2008-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO38024208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84925540Medicaid
CO84925540Medicaid
COC808892Medicare PIN