NPI 1144429507
Tony Wayne Lyle, NAVYIDC
Practice location
- Address
- 1061 Uss Tennessee Ave, Kings Bay, GA 31547
- Phone
- (912) 573-4540
- Mailing address
- 136 Lake Victoria Dr., Kingsland, GA 31548
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1144429507
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 16 Jul 2007
- Record last updated
- 16 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.