Provider Demographics
NPI:1700865060
Name:WARD, LYN D (MD)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:D
Last Name:WARD
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 1:2535 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-382-1577
Mailing Address - Fax:940-387-5471
Practice Address - Street 1:2535 W OAK ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-382-1577
Practice Address - Fax:940-387-5471
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4340207X00000X
TXJ8585207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X5842OtherBCBS TX NUMBER
TX030161605Medicaid
TX1700865060OtherNPI
TX6484850005OtherMEDICARE NSC EFFECT 02/01/2011
TXP00389897OtherRAILROAD MEDICARE
TXP00913309OtherRAILROAD MEDICARE EFFECT 02/01/2011
TX8CR147OtherBCBS TX 02/01/2011
TXTXB117563OtherMEDICARE PART B EFFECT 02/01/2011
TX1700865060OtherNPI
TX5840300001Medicare NSC