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William Michael Lyth

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NPI Number Detailed Information

Provider Information:

Name: William Michael Lyth
Gender: M
Provider License Number If Given: 1010444027

NPI Information:

NPI: 1225031263
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 5/27/2011

Provider Business Mailing Address:

Address: 856 J CLYDE MORRIS BLVD SUITE A
Newport News, VA 23601
Phone Number: 7575944006
Fax Number: 7575345190

Provider Business Practice Location Address:

Address: 618 HOSPITAL RD
Tappahannock, VA 22560
Phone Number: 8044433311
Fax Number: 8044436150

Provider Taxonomy:

Primary: 207L00000X
Secondary (if any):
State: VA

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