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General NPI Number Information
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NPI Number | 1942615083
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Entity Type | Organization
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Legal Business Name | BEN LYNCH O.D., P.A.
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 12/29/2014
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Provider Practice Location Address
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Address Line | 350 E SUNBRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1868
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Country | US
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Telephone | 479-442-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 350 E SUNBRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1868
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. BENJAMIN T LYNCH
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Credential | O.D.
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Telephone | 479-366-0007
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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 | 2703
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License Number State | AR
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