Healthcare Provider Details

I. General information

NPI: 1689950768
Provider Name (Legal Business Name): NEAL MK LYNCH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2011
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 W COLFAX AVE STE B200
LAKEWOOD CO
80215-3736
US

IV. Provider business mailing address

12600 W COLFAX AVE STE B200
LAKEWOOD CO
80215-3736
US

V. Phone/Fax

Practice location:
  • Phone: 303-993-1330
  • Fax: 303-647-3647
Mailing address:
  • Phone: 303-993-1330
  • Fax: 303-647-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3302
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: