Healthcare Provider Details

I. General information

NPI: 1184734758
Provider Name (Legal Business Name): JOAN A LYNCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 20TH ST
HUNTINGTON WV
25703-2019
US

IV. Provider business mailing address

216 SENECA RD
HUNTINGTON WV
25705-4130
US

V. Phone/Fax

Practice location:
  • Phone: 304-529-6100
  • Fax: 304-529-0229
Mailing address:
  • Phone: 304-529-6100
  • Fax: 304-529-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number29316
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number16260
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: