Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2005-00335 | NC |
Y | 207Q00000X | Family Doctor | 51793 | AZ |
NPI | 1003844796 |
---|---|
Provider Name | Dr. Stephen F Lynch |
First Address | Goodyear, AZ 85338-3007 |
Second Address | Goodyear, AZ 85338-3007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 20/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H38828 | (02) | NC |