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General NPI Number Information
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NPI Number | 1982765186
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Entity Type | Individual
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Provider Name | LYNN VIX M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 FISHER STREET
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City | KEESLER AFB
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State | MS
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Zip | 39534
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Country | US
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Telephone | 228-377-6668
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Fax |
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Provider Business Mailing Address
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Address Line | 425 DONWOOD PL
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City | BILOXI
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State | MS
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Zip | 39530-1617
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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 |
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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 | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 20902
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License Number State | NE
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