Provider Demographics
NPI:1366443772
Name:MEHL, LYNETTE RENAE (DPM)
Entity Type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:RENAE
Last Name:MEHL
Suffix:
Gender:F
Credentials:DPM
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Other - First Name:
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Mailing Address - Street 1:6480 HARRISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-713-1779
Mailing Address - Fax:138-549-9215
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2591
Practice Address - Country:US
Practice Address - Phone:614-895-8747
Practice Address - Fax:614-895-8810
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH36003279213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2499292Medicaid
OHME4134423OtherMEDICARE ID
OHV00046Medicare UPIN
OH2499292Medicaid