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General NPI Number Information
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NPI Number | 1205992260
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Entity Type | Individual
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Provider Name | WILLIAM J LYNASS MD OD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 1510 W MAIN ST
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City | STERLING
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State | CO
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Zip | 80751-9095
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Country | US
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Telephone | 970-522-9287
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Fax | 970-522-5953
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Provider Business Mailing Address
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Address Line | 1510 W MAIN ST
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City | STERLING
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State | CO
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Zip | 80751-9095
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Country | US
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Telephone | 970-522-9287
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Fax | 970-522-5953
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2655ATI
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2717
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License Number State | CO
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