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Dr. John Ora Lytle

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NPI Number Detailed Information

Provider Information:

Name: Dr. John Ora Lytle
Gender: M
Provider License Number If Given: C6150

NPI Information:

NPI: 1891780219
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 3/29/2016

Provider Business Mailing Address:

Address: 1609 W 40TH AVE STE 501
Pine Bluff, AR 71603
Phone Number: 8705343449
Fax Number: 8705414297

Provider Business Practice Location Address:

Address: 1609 W 40TH AVE STE 501
Pine Bluff, AR 71603
Phone Number: 8705343449
Fax Number: 8705414297

Provider Taxonomy:

Primary: 207X00000X
Secondary (if any):
State: AR

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