Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 8957471-1205 | UT |
NPI | 1033184775 |
---|---|
Provider Name | Sean F Lynn |
First Address | St George, UT 84790-4084 |
Second Address | St George, UT 84790-4084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 08/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G90728 | (02) | ID |