Healthcare Provider Details
I. General information
NPI: 1770243446
Provider Name (Legal Business Name): JAMES J LYNCH M D LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2021
Last Update Date: 04/07/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9990 DOUBLE R BLVD STE 201
RENO NV
89521-4833
US
IV. Provider business mailing address
5310 KIETZKE LN STE 104
RENO NV
89511-2043
US
V. Phone/Fax
- Phone: 775-348-8800
- Fax: 775-348-8818
- Phone: 775-348-8800
- Fax: 775-348-8818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
JOSEPH
LYNCH
Title or Position: MD
Credential:
Phone: 775-348-8800