Healthcare Provider Details

I. General information

NPI: 1689648313
Provider Name (Legal Business Name): LYNN LENEVE DEYOUNG MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN DEYOUNG HELSETH

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

IV. Provider business mailing address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax: 520-309-2560
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-309-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32975
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: