Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 34453 | MA |
NPI | 1790824282 |
---|---|
Provider Name | Morton D Lynn |
First Address | Springfield, MA 01107-1107 |
Second Address | Springfield, MA 01107-1107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2075636 | (05) | MA |