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NPI Code Detail

MEDICARE: DR. GAYLENE FAYE LYNCH D.O.

MEDICARE: DR. GAYLENE FAYE LYNCH D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician1849IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
354683OTHERIAMEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131549OTHERIAWELLMARK OF IOWA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023008034
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GAYLENE FAYE LYNCH D.O.
Provider Business Mailing Address
First Line : 1230 RIVER VISTA DR
Second Line :
City : DES MOINES
State : IA
Zip : 50315-1050
Country : US
Telephone Number : 515-283-1360
Fax Number : 515-246-8340
Provider Business Practice Location Address
First Line : 802 KENYON RD
Second Line :
City : FORT DODGE
State : IA
Zip : 50501-5740
Country : US
Telephone Number : 515-574-6684
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 03/24/2008

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