MEDICARE: IAN THOMAS LYNCH

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	207R00000X	Internal Medicine Physician	2018020842	MO

General Provider Information

NPI Number	:	1699260562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IAN THOMAS LYNCH

Provider Business Mailing Address
First Line	:	4521 KENTSFIELD LN APT 205
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3558
Country	:	US
Telephone Number	:	812-746-2383
Fax Number	:

Provider Business Practice Location Address
First Line	:	4521 KENTSFIELD LN APT 205
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3558
Country	:	US
Telephone Number	:	812-746-2383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2018
Last Update Date	:	06/25/2021

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Directions to “ IAN THOMAS LYNCH ” Practice Location

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