Provider Demographics
NPI:1629057450
Name:LYNCH, JAMES ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:LYNCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 819
Mailing Address - Street 2:BOX 18-93
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09645
Mailing Address - Country:ES
Mailing Address - Phone:3495-682-3495
Mailing Address - Fax:
Practice Address - Street 1:PSC 819
Practice Address - Street 2:BOX 18
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09645
Practice Address - Country:ES
Practice Address - Phone:3495-682-0035
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000122152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist