Provider Demographics
NPI:1699765685
Name:WALKER, LYNN R (MD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:R
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5532 OLD FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8637
Mailing Address - Country:US
Mailing Address - Phone:810-694-7412
Mailing Address - Fax:810-344-9215
Practice Address - Street 1:12741 S SAGINAW ST
Practice Address - Street 2:SUITE 402
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2460
Practice Address - Country:US
Practice Address - Phone:810-694-7412
Practice Address - Fax:810-344-9215
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2013-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301053372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0988458OtherHEALTH PLUS
MI4764096Medicaid
MI0802511741OtherBCBS
MI0988458OtherHEALTH PLUS
P21430001Medicare ID - Type Unspecified