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NPI 1003194556

NPI 1003194556 : DR. MARK LYNN & ASSOCIATES, PLLC : HENDERSONVILLE, TN

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General NPI Number Information
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    NPI Number           |    1003194556
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    Entity Type          |    Organization 
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    Legal Business Name  |    DR. MARK LYNN & ASSOCIATES, PLLC 
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Dates
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    Enumeration Date     |    08/02/2011
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    Last Update Date     |    08/08/2013
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Provider Practice Location Address
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    Address Line         |    254 INDIAN LAKE BLVD., SUITE 100
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    City                 |    HENDERSONVILLE
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    State                |    TN
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    Zip                  |    37075
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    Country              |    US
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    Telephone            |    615-822-0446
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 846027 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75284-6027
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    Country              |    US
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    Telephone            |    180-034-9512
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    Fax                  |    210-524-6587
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. MARK  LYNN 
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    Credential           |    O.D.
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    Telephone            |    812-285-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332H00000X
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    Taxonomy Name        |    Eyewear Supplier
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    License Number       |    
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    License Number State |    
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