Provider Demographics
NPI:1407466915
Name:LYMAN, RONNIE JR
Entity type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:
Last Name:LYMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 RICHMOND HWY APT 554
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-1771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8TH MEDICAL GROUP
Practice Address - Street 2:BLD 504
Practice Address - City:KUNSAN AFB
Practice Address - State:AP
Practice Address - Zip Code:96264
Practice Address - Country:KR
Practice Address - Phone:315-782-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical