Provider Demographics
NPI:1871560755
Name:LYONS, KAREN S (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:LYONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PARK ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1784
Mailing Address - Country:US
Mailing Address - Phone:270-781-0075
Mailing Address - Fax:270-781-0143
Practice Address - Street 1:350 PARK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1784
Practice Address - Country:US
Practice Address - Phone:270-781-0075
Practice Address - Fax:270-781-0143
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34953207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64058555Medicaid
H64877Medicare UPIN
KY64058555Medicaid