Provider Demographics
NPI:1003826389
Name:ESKELSON, LYNN PERRINS (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:PERRINS
Last Name:ESKELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 UINTA DR
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-5060
Mailing Address - Country:US
Mailing Address - Phone:307-872-4500
Mailing Address - Fax:307-872-4595
Practice Address - Street 1:1400 UINTA DR
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5060
Practice Address - Country:US
Practice Address - Phone:307-872-4500
Practice Address - Fax:307-872-4595
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4058A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002667800Medicaid
ID002667800Medicaid
IDE51065Medicare UPIN