Provider Demographics
NPI:1225456403
Name:LYNES, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LYNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 RESERVOIR RD NW
Mailing Address - Street 2:DEPT OF NEUROSURGERY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2113
Mailing Address - Country:US
Mailing Address - Phone:202-444-4972
Mailing Address - Fax:202-444-7344
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:DEPT OF NEUROSURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-4972
Practice Address - Fax:202-444-7344
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101275884207T00000X
390200000X
DCMD045634207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program