Healthcare Provider Details

I. General information

NPI: 1487162475
Provider Name (Legal Business Name): WILLIAM BRYON LYNN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

8005 CLOUGH PIKE
CINCINNATI OH
45244-2952
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8282
  • Fax:
Mailing address:
  • Phone: 513-473-2001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number119830
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: