Healthcare Provider Details

I. General information

NPI: 1366485229
Provider Name (Legal Business Name): JAMES EDWARD LYNCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE S. BRYANT AVE.
EDMOND OK
73034-6309
US

IV. Provider business mailing address

1 S BRYANT AVE
EDMOND OK
73034-6309
US

V. Phone/Fax

Practice location:
  • Phone: 405-359-5370
  • Fax: 405-359-5357
Mailing address:
  • Phone: 405-359-5370
  • Fax: 405-359-5357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19088
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number19088
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: