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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 |
