Provider Demographics
NPI:1346449733
Name:LYNN & YORK, OPTOMETRISTS, PC
Entity Type:Organization
Organization Name:LYNN & YORK, OPTOMETRISTS, PC
Other - Org Name:SANGO EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BART
Authorized Official - Middle Name:D
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:931-647-8417
Mailing Address - Street 1:2699 TOWNSEND CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6487
Mailing Address - Country:US
Mailing Address - Phone:931-647-8417
Mailing Address - Fax:931-648-4435
Practice Address - Street 1:2699 TOWNSEND CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6487
Practice Address - Country:US
Practice Address - Phone:931-647-8417
Practice Address - Fax:931-648-4435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000001639152W00000X, 152W00000X
TNOD2869152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ009057Medicaid
TN3599833Medicare PIN
TNQ009057Medicaid
TN0618580002Medicare NSC