Lyda, Kenneth Eugene

Lyda, Kenneth Eugene is an individual health care provider with primary practice located at 275 Collier Rd Nw Ste 500, Atlanta GA 30309-1709. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Lyda, Kenneth Eugene can be contacted via phone (404) 605-2800.

Contact Information

Primary practice address
275 Collier Rd Nw Ste 500 Atlanta GA 30309-1709
Phone: (404) 605-2800
Fax: (404) 351-5983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 124797 Georgia

Profile Details

NPI number 1043215999
LBN Legal business name Lyda, Kenneth Eugene
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated May 16th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043215999 NPPES
Georgia MEDICAID 000925801P

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