Lyons Family Practice
Organization Active NPI Family Medicine Physician · Lyons, GA
NPI 1194909010 · NPPES record last updated Apr 23, 2009
Key facts
- NPI
- 1194909010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LYONS FAMILY PRACTICE
- Practice address
- 113 Moody Cir
Lyons, GA 30436-1428 - Phone
- (912) 526-6567
- Fax
- (912) 526-0471
- NPI assigned
- Dec 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. John Milton Moody, M.D.
- Title
- Owner
- Phone
- (912) 526-6567
Practitioners 1
-
Michael G Wiggins, FNP
National Provider Directory
Locations
127 Moody Cir
Lyons, GA 30436
Phone (912) 526-4446
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
113 Moody Cir
Lyons, GA 30436-1428
Mailing address
113 Moody Cir
Lyons, GA 30436-1428
Phone (912) 526-6567
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000478596G | Medicaid | GA | |
| 034904 | Other | GA | GEORGIA STATE BOARD OF MEDICAL EXAMINERS |
Other providers in Lyons, GA
- JF8 Laboratories, LLC
- K & H Med-Trans
- Greggory Theotis Kent
- Kid'S Spot, LLC
- Tommy Kirkley
- Lyons Family Practice
- Hazel E Mead
- Meadows Multispecialty Associates, LLC
- Medivan Transport, LLC
- Jay Mosley
All providers in Lyons, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.