Provider Demographics
NPI:1194852574
Name:LYNN INSTITUTE OF THE OZARKS
Entity Type:Organization
Organization Name:LYNN INSTITUTE OF THE OZARKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATIVE AND FINA
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:POJEZNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-602-3931
Mailing Address - Street 1:3555 NW 58TH ST
Mailing Address - Street 2:STE. 800
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4707
Mailing Address - Country:US
Mailing Address - Phone:405-602-3939
Mailing Address - Fax:405-602-3945
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:STE. 305
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-975-1966
Practice Address - Fax:501-975-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00763332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5689580001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT