| Shaunna M Lyon, MD | |
|
N2950 State Road 67, Lake Geneva, WI 53147-2655 | |
| (262) 245-0535 | |
| (262) 245-2248 |
| Full Name | Shaunna M Lyon |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | N2950 State Road 67, Lake Geneva, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891904546 | NPI | - | NPPES |
| LYONSHA | Other | WI | MERCYCARE INSURANCE |
| 1891904546 | Medicaid | WI | |
| 54309 | Other | IA | WELLMARK BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | R-7249 (Iowa) | Secondary |
| 208000000X | Pediatrics | 37206 (Iowa) | Secondary |
| 208000000X | Pediatrics | 55298-20 (Wisconsin) | Primary |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031113000164 |
| Mailing Address | Practice Location Address |
|---|---|
| Shaunna M Lyon, MD N2950 State Road 67, Lake Geneva, WI 53147-2655 Ph: (262) 245-0535 | Shaunna M Lyon, MD N2950 State Road 67, Lake Geneva, WI 53147-2655 Ph: (262) 245-0535 |
Dr. Jake S Vacarella, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Dr. Julia R Dewey, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Lora A Nerland, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Dr. Danny Mackenzie Jr., DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 146 E Geneva Sq, Lake Geneva, WI 53147 Phone: 262-249-5000 |