Healthcare Provider Details

I. General information

NPI: 1306829536
Provider Name (Legal Business Name): KATHRYN L LYNCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 S COTTONWOOD RD STE 200
BOZEMAN MT
59718-4208
US

IV. Provider business mailing address

875 S COTTONWOOD RD STE 200
BOZEMAN MT
59718-4208
US

V. Phone/Fax

Practice location:
  • Phone: 406-414-5336
  • Fax: 406-414-5337
Mailing address:
  • Phone: 406-414-5336
  • Fax: 406-414-5337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number11735
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: