Healthcare Provider Details

I. General information

NPI: 1851386056
Provider Name (Legal Business Name): EDWARD FRANKLIN LYNCH JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12311 PERRY HWY
WEXFORD PA
15090-8344
US

IV. Provider business mailing address

12311 PERRY HWY
WEXFORD PA
15090-8344
US

V. Phone/Fax

Practice location:
  • Phone: 878-322-4284
  • Fax: 878-332-4484
Mailing address:
  • Phone: 878-322-4284
  • Fax: 878-332-4484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberMD053107L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD053107L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: