Basic Information
| Provider Information | |||||||||
| NPI: | 1477511640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYON-LOFTUS | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 ST PAUL DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172176760 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 10/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD030841E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | AL9284302 | 01 | PA | DEA | OTHER | 098361 | 01 | PA | HIGHMARK BLUESHIELD | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 50074257 | 01 | PA | CAPITAL BLUECROSS | OTHER | P009384 | 01 | PA | GATEWAY | OTHER | 120420417 | 01 | PA | DEPT OF LABOR | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | 226929 | 01 | PA | UNISON | OTHER | 4294849 | 01 | PA | AETNA NON-HMO | OTHER | 000970837 0001 | 05 | PA | MEDICAID | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 718122 | 01 | PA | HEALTH AMERICA | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 841638 | 01 | PA | AETNA HMO | OTHER | G920-0110/KDM4CU | 01 | PA | CAREFIRST | OTHER | MD030841E | 01 | PA | LICENSE | OTHER | P00390475 | 01 | PA | RAILROAD MEDICARE | OTHER |