Provider Demographics
NPI:1821154592
Name:NESBITT, LYNN ROYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ROYCE
Last Name:NESBITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:468 FM 1287
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-6784
Mailing Address - Country:US
Mailing Address - Phone:940-550-8191
Mailing Address - Fax:940-549-5550
Practice Address - Street 1:1301 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4240
Practice Address - Country:US
Practice Address - Phone:940-550-8191
Practice Address - Fax:940-549-5550
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine