MEDICARE: DR MARK LYNN & ASSOCIATES PLLC

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
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1205206588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR MARK LYNN & ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 846027
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6027
Country	:	US
Telephone Number	:	800-340-0129
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	5307 HIGHWAY 153
Second Line	:	101
City	:	HIXSON
State	:	TN
Zip	:	37343-4912
Country	:	US
Telephone Number	:	423-877-3309
Fax Number	:	423-877-3310

Authorized Official
Title or Position	:	OWNER
Name	:	MARK E LYNN
Credential	:	O.D.
Telephone Number	:	502-443-4444

Provider Enumeration Date	:	09/30/2015
Last Update Date	:	09/30/2015

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