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Contact Information

EZRA LYON, MD
710 RIVERSIDE DR
WAUPACA, WI54981-1941
 Phone: 715-256-3000
 Fax: 715-256-3079
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Obstetrics

207VX0000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for EZRA LYON · (Male)

NPI # 1669906004
Status Active
Credentials MD
Entity Individual
Enumeration date 04/12/2017
Last updated 02/11/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • WI License # 69896
Hospital affiliation(s)
  • NEW LONDON FAMILY MED CTR - (Critical Access)
    1405 MILL ST
    NEW LONDON, WI 54961
  • RIVERSIDE MEDICAL CENTER - (Critical Access)
    800 RIVERSIDE DRIVE
    WAUPACA, WI 54981
  • THEDA CLARK MED CTR - (Acute Care)
    130 2ND ST
    NEENAH, WI 54956
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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