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General NPI Number Information
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NPI Number | 1043768039
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Entity Type | Organization
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Legal Business Name | MARK LYNN OD & ASSOCIATES, PC
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 7300 N POINT PKWY STE 122
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City | ALPHARETTA
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State | GA
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Zip | 30022-4818
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Country | US
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Telephone | 770-752-0763
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Fax | 770-752-0764
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Provider Business Mailing Address
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Address Line | PO BOX 848560
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City | DALLAS
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State | TX
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Zip | 75284-8560
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Country | US
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Telephone | 800-349-5120
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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 | MARK LYNN
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Credential | OD
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Telephone | 502-423-4444
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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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