Provider Demographics
NPI:1568467397
Name:FLYNN, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:FLYNN
Suffix:
Gender:M
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:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-0550
Mailing Address - Country:US
Mailing Address - Phone:740-687-5164
Mailing Address - Fax:740-654-1417
Practice Address - Street 1:6760 AVERY MUIRFIELD DR
Practice Address - Street 2:STE A
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1232
Practice Address - Country:US
Practice Address - Phone:614-791-9952
Practice Address - Fax:614-791-9953
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-048544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0584149Medicaid
OH0584149Medicaid
080165056Medicare PIN