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General NPI Number Information
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NPI Number | 1366526626
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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 | 10/24/2006
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 3042 WILLIAM ST
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-6389
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Country | US
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Telephone | 573-339-2008
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Fax | 573-339-1020
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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 | 210-524-6663
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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 | 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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