Provider Demographics
NPI:1033180468
Name:WILLIAMS, LYNN R (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1131
Mailing Address - Country:US
Mailing Address - Phone:724-656-8940
Mailing Address - Fax:724-656-8942
Practice Address - Street 1:3105 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1131
Practice Address - Country:US
Practice Address - Phone:724-656-8940
Practice Address - Fax:724-656-8942
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042981L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13102OtherUPMC
PA7993414OtherAETNA US HEALTHCARE
PA142244OtherADVANTRA
PA3046212OtherUS HEALTHCARE
PA001332161OtherHIGHMARK BLUE SHIELD
PA070015974 & CK4548OtherTRAVELERS RAILROAD MEDICA
PA142244OtherHEALTHAMERICA/ASSURANCE
PA251880884OtherFEDERAL TAX I.D. NUMBER
PA142244OtherHEALTHAMERICA/ASSURANCE
PA001332161OtherHIGHMARK BLUE SHIELD
PA7993414OtherAETNA US HEALTHCARE