Provider Demographics
NPI:1528055886
Name:LYNCH, ALISON CORNELIA (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:CORNELIA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:CORNELIA
Other - Last Name:ABREU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 HAWKINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-384-7000
Mailing Address - Fax:319-384-7901
Practice Address - Street 1:200 HAWKINS DRIVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-384-7000
Practice Address - Fax:319-384-7901
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33208207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0422600Medicaid
IA35629OtherWELLMARK BCBS
IA35629OtherWELLMARK BCBS
H96568Medicare UPIN
IA0422600Medicaid