WILLIAM BRADFORD LYLES (NPI# 1386799328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386799328 |
| Entity Type | Individual |
| Full Name | WILLIAM BRADFORD LYLES |
| Credential | M.D. |
| Practice Address |
840 Willard Dr Suite 201 Green Bay WI 54304-5204 |
| Practice Telephone | 9204970788 |
| Mailing Telephone | 9204970788 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
40554-020 | WI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
40554-020 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356846802 | William Lyles | Technician | 4421 F St Se, Washington, DC 20019-5043 | 2018-03-27 |
| 1750364782 | William Elwyn Lyles | Internal Medicine | 355 Bmh Physicians Office Bldg, Maryville, TN 37804-5820 | 2005-11-23 |
| 1851500128 | William H Lyles | Occupational Therapist | 4001 Home St, Castle Rock, CO 80108-2802 | 2007-05-22 |
| 1801001912 | William D Lyles Jr. | Family Medicine | 205 Broadway, Hartsville, TN 37074-1303 | 2007-05-11 |
| 1215964408 | William Bennett Lyles | Nurse Practitioner | 4230 Harding Rd, Suite 330, Nashville, TN 37205-2013 | 2006-06-26 |
| Street Address |
840 WILLARD DR SUITE 201 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-5204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740334770 | Kennan F Horn | Marriage & Family Therapist | 840 Willard Dr, Suite 201, Green Bay, WI 54304-5204 | 2007-01-23 |
| 1063693273 | Child and Family Consultants | Clinic/Center | 840 Willard Dr, Suite 201, Green Bay, WI 54304-5204 | 2007-11-15 |
| 1578617502 | Cheryl K Rotherham | Marriage & Family Therapist | 840 Willard Dr, Suite 102, Green Bay, WI 54304-5204 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447262183 | Neil P Fullan | Psychiatry & Neurology | 2475 University Ave Ste A, Green Bay, WI 54302-5099 | 2006-08-12 |
| 1790775450 | Derek Carl Carlson | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2005-10-25 |
| 1356502561 | Jennifer E. Montgomery Fischer | Psychiatry & Neurology | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2008-06-19 |
| 1578761797 | Richa Aggarwal | Psychiatry & Neurology | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2007-07-10 |
| 1275518474 | Edward S Orman | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104384387 | Center for Emotional Wellness LLC. | Psychiatry & Neurology | W156n8327 Pilgrim Rd Ste 301, Menomonee Fls, WI 53051-3776 | 2019-03-06 |
| 1295000255 | Ilsa Bick | Psychiatry & Neurology | 1099 Highland Dr, Kohler, WI 53044-1306 | 2012-03-09 |
| 1215268453 | Richard Carl Zimmerman | Psychiatry & Neurology | 1282 E. Green Lake Dr., West Bend, WI 53090-9069 | 2010-01-28 |
| 1184800880 | William M Buzogany | Psychiatry & Neurology | W350 S1401 Waterville Road, Lad Lake Inc, Dousman, WI 53118 | 2008-01-14 |
| 1033300199 | Monika Drummond Roots | Psychiatry & Neurology | 3140 Oxford Rd, Madison, WI 53705-2224 | 2007-08-05 |
| 1598974321 | Marta Cristina Muller | Psychiatry & Neurology | 1941 N Battle Creek Rd, Oconomowoc, WI 53066-9468 | 2007-05-21 |
| 1164517082 | Moitreyee Bandyopadhyay Reddy | Psychiatry & Neurology | 9000 W.wisconsin Avenue, Milwaukee, WI 53201-1997 | 2006-10-04 |
| 1639182868 | Thomas E. Wright | Psychiatry & Neurology | 120 East Main Street, Cambridge, WI 53523-0548 | 2006-08-15 |
| 1396761276 | Robert Perzacki | Psychiatry & Neurology | 1820 Appleton Rd, Menasha, WI 54952-1110 | 2006-07-14 |
| 1730134412 | Tracey Cornella-carlson | Psychiatry & Neurology | 721 American Ave Ste 501, Waukesha, WI 53188-5071 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.