Charles E Lyon, MD, Apmc
Optometrist in Shreveport, LA. Organization (NPI-2).
NPI number1689789562
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1689789562
- Entity type
- Organization (NPI-2)
- Legal business name
- Charles E Lyon, MD, Apmc
- Organization subpart
- No
- Enumeration date
- Aug 20, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
| 207W00000X | Ophthalmology | – | – |
Other names
- Vitreo-Retinal Associates (Former Legal Business Name)
Practice location
836 Olive StShreveport, LA 71104-2102
Phone 318-222-8421 · Fax 318-673-8970
Mailing address
836 Olive StShreveport, LA 71104-2102
Phone 318-222-8421 · Fax 318-673-8970
Authorized official
Charles E Lyon
President
3182228421
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