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NPI Code Detail

MEDICARE: DR. MAURICE JOSE LYN O.D.

MEDICARE: DR. MAURICE JOSE LYN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristR119TA114AL

General Provider Information

NPI Number : 1801859400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURICE JOSE LYN O.D.
Provider Business Mailing Address
First Line : 638 CLANTON MARKETPLACE
Second Line :
City : CLANTON
State : AL
Zip : 35045-2246
Country : US
Telephone Number : 205-755-3636
Fax Number : 205-755-3777
Provider Business Practice Location Address
First Line : 638 CLANTON MARKETPLACE
Second Line :
City : CLANTON
State : AL
Zip : 35045-2246
Country : US
Telephone Number : 205-755-3636
Fax Number : 205-755-3777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 04/01/2009

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