Provider Demographics
NPI:1992762009
Name:LYNCH, DONALD RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RICHARD
Last Name:LYNCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1514 SAINT MARYS DR
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-5022
Mailing Address - Country:US
Mailing Address - Phone:912-283-7861
Mailing Address - Fax:912-283-7026
Practice Address - Street 1:1507 ALICE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-4530
Practice Address - Country:US
Practice Address - Phone:912-283-7220
Practice Address - Fax:912-283-7026
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA014927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE01109Medicare UPIN