Provider Demographics
NPI:1992127138
Name:DR MARK LYNN & ASSOCIATES, PLLC
Entity type:Organization
Organization Name:DR MARK LYNN & ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:502-423-4444
Mailing Address - Street 1:PO BOX 846027
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6027
Mailing Address - Country:US
Mailing Address - Phone:210-340-3531
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:800 N GREEN RIVER RD
Practice Address - Street 2:SPACE #205
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2471
Practice Address - Country:US
Practice Address - Phone:812-475-1946
Practice Address - Fax:812-475-1947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier