Ezra Lyon, M.D.
Family Medicine in Wausau, WI. Individual provider (NPI-1).
NPI number1669906004
StatusActive
Last updated in NPPESJul 10, 2026
Details
- NPI
- 1669906004
- Entity type
- Individual (NPI-1)
- Name
- Ezra Lyon
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2017
- Certification date
- Jul 10, 2026
- Last updated
- Jul 10, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 69896 | WI | Yes |
| 207VX0000X | Obstetrics & Gynecology, Obstetrics | 69896 | WI |
Practice location
1810 N 2nd StWausau, WI 54403-3492
Phone 715-848-4884 · Fax 715-845-5385
Mailing address
1810 N 2nd StWausau, WI 54403-3492
Phone 715-848-4884 · Fax 715-845-5385
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