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General NPI Number Information
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NPI Number | 1477578599
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Entity Type | Individual
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Provider Name | JONATHAN P LYNCH MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 1178 5TH ST SE
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City | CAIRO
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State | GA
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Zip | 39828-3141
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Country | US
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Telephone | 229-377-2002
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Fax | 229-377-0930
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Provider Business Mailing Address
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Address Line | 1178 5TH ST SE
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City | CAIRO
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State | GA
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Zip | 39828-3141
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Country | US
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Telephone | 229-377-2002
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Fax | 229-377-0930
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TL27868
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 060402
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License Number State | GA
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