Provider Demographics
NPI:1497728497
Name:VU, LYNDA K (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:K
Last Name:VU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2164 PRINCESS DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-8005
Mailing Address - Country:US
Mailing Address - Phone:702-556-5042
Mailing Address - Fax:
Practice Address - Street 1:2510 5TH ST
Practice Address - Street 2:USAF SCHOOL OF AEROSPACE MEDICINE
Practice Address - City:WPAFB
Practice Address - State:OH
Practice Address - Zip Code:45433-7951
Practice Address - Country:US
Practice Address - Phone:937-938-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine