Provider Demographics
NPI:1275701005
Name:LYNN HEALTH SCIENCE INSTITUTE
Entity Type:Organization
Organization Name:LYNN HEALTH SCIENCE INSTITUTE
Other - Org Name:COLORADO INSTITUTE OF SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-602-3919
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 1:2500 N CIRCLE DR
Practice Address - Street 2:STE. 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1184
Practice Address - Country:US
Practice Address - Phone:719-636-3784
Practice Address - Fax:719-630-3211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LYNN HEALTH SCIENCE INSTITUE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86220241Medicaid
CO86220241Medicaid