Provider Demographics
NPI:1588047443
Name:LYNCH, WHITNEY DANJACK (DO)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:DANJACK
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:W.
Other - Middle Name:DAN
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1051 GAUSE BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2951
Practice Address - Country:US
Practice Address - Phone:985-898-7420
Practice Address - Fax:985-661-3587
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13653204D00000X
LA341364207RA0401X
MS26556204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty