Provider Demographics
NPI:1124396767
Name:WHELCHEL, LYNN WALTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:WALTON
Last Name:WHELCHEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:273 SMITH HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06021-7093
Mailing Address - Country:US
Mailing Address - Phone:860-379-7120
Mailing Address - Fax:
Practice Address - Street 1:273 SMITH HILL RD
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:CT
Practice Address - Zip Code:06021-7093
Practice Address - Country:US
Practice Address - Phone:860-379-7120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-11
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT016089208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)