MEDICARE: LYNCH VEIN AND AESTHETICS 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	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1922616143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNCH VEIN AND AESTHETICS PLLC

Provider Business Mailing Address
First Line	:	26900 N LAKE PLEASANT PKWY
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-1558
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26900 N LAKE PLEASANT PKWY
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-1558
Country	:	US
Telephone Number	:	623-524-8960
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/MEDICAL DIRECTOR
Name	:	MATTHEW LYNCH
Credential	:	MD
Telephone Number	:	608-745-2555

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	01/18/2021

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