Lyles, Kenneth W

Lyles, Kenneth W is an individual health care provider with primary practice located at 4101 N Roxboro St , Durham NC 27704-2121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Lyles, Kenneth W can be contacted via phone (919) 684-8111.

Contact Information

Primary practice address
4101 N Roxboro St Durham NC 27704-2121
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 23405 North Carolina

Profile Details

NPI number 1184706418
LBN Legal business name Lyles, Kenneth W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jul 8th, 2007 - about 17 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 1184706418 NPPES
North Carolina MEDICAID 8953463

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