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NPI Code Detail

MEDICARE: BEVERLY J LYNCH MD

MEDICARE: BEVERLY J LYNCH MD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician326821-1205UT

General Provider Information

NPI Number : 1962441410
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY J LYNCH MD
Provider Business Mailing Address
First Line : PO BOX 276
Second Line :
City : MIDVALE
State : UT
Zip : 84047-0276
Country : US
Telephone Number : 801-263-0810
Fax Number : 801-270-8170
Provider Business Practice Location Address
First Line : 750 W 800 N
Second Line :
City : OREM
State : UT
Zip : 84057-3660
Country : US
Telephone Number : 801-263-0810
Fax Number : 801-270-8170
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 03/25/2014

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