Provider Demographics
NPI:1306829536
Name:LYNCH, KATHRYN L (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:L
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:875 S COTTONWOOD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-4208
Mailing Address - Country:US
Mailing Address - Phone:406-414-5336
Mailing Address - Fax:406-414-5337
Practice Address - Street 1:875 S COTTONWOOD RD STE 200
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-4208
Practice Address - Country:US
Practice Address - Phone:406-414-5336
Practice Address - Fax:406-414-5337
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11735207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLYLY6550OtherANTHEM BCBS
CO88920828Medicare ID - Type Unspecified
COLYLY6550OtherANTHEM BCBS
COH44471Medicare UPIN