| William D Lyles Jr, MD | |
|
205 Broadway, Hartsville, TN 37074-1303 | |
| (615) 374-0703 | |
| (615) 374-0019 |
| Full Name | William D Lyles Jr |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 205 Broadway, Hartsville, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801001912 | NPI | - | NPPES |
| 3860457 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 16864 (Tennessee) | Primary |
| 207V00000X | Obstetrics & Gynecology | 16864 (Tennessee) | Secondary |
| Entity Name | Concord Medical Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083630610 PECOS PAC ID: 0446296818 Enrollment ID: O20151006000818 |
| Mailing Address | Practice Location Address |
|---|---|
| William D Lyles Jr, MD 205 Broadway, P.o. Box 486, Hartsville, TN 37074-1303 Ph: (615) 374-0703 | William D Lyles Jr, MD 205 Broadway, Hartsville, TN 37074-1303 Ph: (615) 374-0703 |
Jack W Carey Jr., MD Family Medicine Medicare: Medicare Enrolled Practice Location: 220 Broadway, Hartsville, TN 37074 Phone: 615-374-2101 Fax: 615-374-4560 | |
Mr. Samuel C. Moore, PMHNP FNP-C Family Medicine Medicare: Medicare Enrolled Practice Location: 140 Macon Way, Hartsville, TN 37074 Phone: 615-808-0400 | |
Floyd Reed Jr., MD Family Medicine Medicare: Medicare Enrolled Practice Location: 213 Broadway, Hartsville, TN 37074 Phone: 615-374-9275 Fax: 615-374-9281 |