Healthcare Provider Details

I. General information

NPI: 1669157319
Provider Name (Legal Business Name): JAMES J LYNCH M D LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1749 N STEWART ST STE 50
CARSON CITY NV
89706-2574
US

IV. Provider business mailing address

5310 KIETZKE LN STE 104
RENO NV
89511-2043
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-8800
  • Fax: 775-348-8818
Mailing address:
  • Phone: 775-348-8800
  • Fax: 833-687-1419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JENNY ALBIOS
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 623-241-8730