Provider Demographics
NPI:1053484790
Name:FOX, LYNN A (OD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:FOX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:A
Other - Last Name:EVERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:4227 MACDUFF WAY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9511
Mailing Address - Country:US
Mailing Address - Phone:614-389-2265
Mailing Address - Fax:
Practice Address - Street 1:1325 CAMERON AVE
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9662
Practice Address - Country:US
Practice Address - Phone:614-888-3972
Practice Address - Fax:614-888-3709
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5779152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist